الفهرس 
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Abstract
Colorectal cancer is the third most common type of cancer and the fourth leading cause of cancer mortality diagnosed worldwide. The data about the prevalence of CRC in Egypt are lacking.
CRC screening is conducted with a variety of tests, most commonly colonoscopy. Screening colonoscopy reduces CRC incidence and mortality. CRC screening is recommended at age of 50 for high risk people. CRC incidence has increased recently among younger age group.
The study carried out on 200 patients presented to the Gastrointestinal Surgery Unit, Main Alexandria University Hospital complaining of lower gastrointestinal symptoms and/or at high risk of CRC, 32 of them with family history of CRC. They were 92 males and 108 females with age range 20-83 years. All of them were subjected to detailed history taking, physical examination and routine investigations. Further dedicated laboratory investigations and imaging studies were done for selected cases. Bowel preparation was done for all patients using; oral preparation (Fortrans®) and Enema.
Complete colonoscopic examination was done in 188 patients. In 12 patients the colonoscopic examination was incomplete because of bad bowel preparation or presence of constrictive lesions.
Complication of the colonoscopy was seen in 4 patients with Gastro-intestinal bleeding and 4 patients with post-polypectomy syndrome.
Colonoscopic biopsy was done for patients with positive findings and sent for histopathology examination.
In our study 18 patients (9%) had CRC; 4 patients diagnosed as hereditary CRC, with mass size ranged from 1.5-9.2cm; 10 of them were males (two patients aged > 40) and 8 of them were females (one patient aged >40), most of them CRC was located in the left colon and rectum.
Polypectomy and EMR was done for 50 patients (25%) with one or more polyp, polyp size ranged from 3-23mm. 42 patients with solitary polyp while 12 patients with multiple polyps. According to paris classification 72.7% of polyps were 0-IP and 27.3% of polyps were 0-IS. After histopathology examination, 44 cases with adenomatous polyp, 8 hyperplastic polyps and 2 with inflammatory polyps.
ADR was 22%, 24 patients with adenoma were males and 20 patients were females,15 of the male patients and 14 of the female patients age ranged from 40-60. More than 60% of polyps found in the left colon and rectum.
Sixteen patient with CRC and 4 patients with FAP were operated by open surgery, two patients with left colon cancer were operated laparoscopically.
All patients with polyps were referred for CRC screening guidelines.