Increasing Rates of Surgery for Patients With Nonmalignant Colorectal Polyps in the United States

Abstract

Background & aims: Despite the availability of endoscopic therapy, many patients in the United States undergo surgical resection for nonmalignant colorectal polyps. We aimed to quantify and examine trends in the use of surgery for nonmalignant colorectal polyps in a nationally representative sample.

Methods: We analyzed data from the Healthcare Cost and Utilization Project National Inpatient Sample for 2000 through 2014. We included all adult patients who underwent elective colectomy or proctectomy and had a diagnosis of either nonmalignant colorectal polyp or colorectal cancer. We compared trends in surgery for nonmalignant colorectal polyps with surgery for colorectal cancer and calculated age, sex, race, region, and teaching status/bed-size-specific incidence rates of surgery for nonmalignant colorectal polyps.

Results: From 2000 through 2014, there were 1,230,458 surgeries for nonmalignant colorectal polyps and colorectal cancer in the United States. Among those surgeries, 25% were performed for nonmalignant colorectal polyps. The incidence of surgery for nonmalignant colorectal polyps has increased significantly, from 5.9 in 2000 to 9.4 in 2014 per 100,000 adults (incidence rate difference, 3.56; 95% confidence interval 3.40-3.72), while the incidence of surgery for colorectal cancer has significantly decreased, from 31.5 to 24.7 surgeries per 100,000 adults (incidence rate difference, -6.80; 95% confidence interval -7.11 to -6.49). The incidence of surgery for nonmalignant colorectal polyps has been increasing among individuals age 20 to 79, in men and women and including all races and ethnicities.

Conclusions: In an analysis of a large, nationally representative sample, we found that surgery for nonmalignant colorectal polyps is common and has significantly increased over the past 14 years.

Keywords: Adenomatous Polyps; Colectomy; Colonic Polyps; Intestinal Polyps.

Figure 1

Annual incidence rate for non-malignant colorectal polyp and colorectal cancer surgery per 100,000 US adults (≥20 years old) in the United States between 2000 and 2014

Figure 2

Annual incidence rate for non-malignant colorectal polyp surgery per 100,000 US adults, stratified by age.

Figure 3

Annual incidence rate for non-malignant colorectal polyp surgery per 100,000 US adults, stratified by hospital region.

Figure 4

Annual incidence rate for non-malignant colorectal polyp surgery per 100,000 US adults, among A) urban, teaching hospitals, B) urban, nonteaching hospitals, and C) rural, nonteaching hospitals, stratified by bed size.