目的： 分析40~59岁无症状人群的结肠直肠腺瘤和胃息肉检出情况,同时探讨胃息肉患者是否是结肠直肠癌（colorectal cancer,CRC）筛查的新目标人群。方法： 本研究收集11 918名40~59岁的一般风险人群（包括男性5 616人,女性6 302人）,为2015年1月至2018年12月间在上海交通大学医学院附属瑞金医院内镜中心首次行麻醉结肠镜检查者,且均自愿行胃镜检查,按照年龄间隔5岁和性别进行分层。根据病理活检结果收集胃息肉组和胃镜阴性组,比较2组间的结肠直肠息肉、腺瘤和进展期腺瘤检出情况及临床特点。结果： 本研究11 918名研究对象中,结肠直肠息肉、腺瘤和进展期腺瘤的总体检出率分别为10.7%、15.4%和3.6%。在男性中,结肠直肠息肉、腺瘤和进展期腺瘤的总体检出率分别为14.0%、19.8%和4.7%;在女性中,三者的检出率分别为7.6%、11.4%和2.7%。胃息肉组的结肠直肠腺瘤检出率显著高于胃镜阴性组（16.7%比11.7%）（P<0.001）。在胃息肉组中,45~49岁男性的结肠直肠腺瘤检出率显著高于40~44岁男性（26.7%比14.6%）（P=0.031）,但与50~54岁（18.8%,29/154）及55~59岁（26.3%,41/156）男性相比,差异无统计学意义。女性40~44岁和45~49岁的结肠直肠腺瘤检出率均较低,分别为7.6%（10/132）和11.2%（21/187）。结论： 上海40~59岁无症状人群中,结肠直肠腺瘤检出率为3.6%;CRC一般风险的45~49岁男性胃息肉患者是结肠镜筛查的新目标人群。

Objective: To investigate the detection rate of colorectal adenoma and gastric polyps in the asymptomatic population with the age of 40 to 59 years and to explore whether the patients with gastric polyps were the new target population for the colorectal cancer (CRC) screening. Methods: A total of 11 918 subjects of 40 to 59 years (5 616 males and 6 302 females) with the average risk of CRC were included during January 2015 to December 2018 at the endoscopy center of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. All the subjects underwent colonoscopy and volunteered to undergo esophagogastroduodenoscopy (EGD), and were grouped by the age interval of 5 years and gender. The patients with gastric polyp (GP group) and with EGD negative results (EGD negative group) were enrolled based on the pathological biopsy results, and the clinical characteristics and detection rate of colorectal polyp, adenoma and advanced adenoma were compared between two groups. Results: The overall detection rate of colorectal poly,adenoma,and advanced adenoma were 10.7%, 15.4%, and 3.6%, respectively. For the male subjects, the detection rates of colorectal polys, adenoma, and advanced adenoma were 14.0%, 19.8% and 4.7%, respectively,while for the female subjects, the corresponding rates were 7.6%, 11.4% and 2.7%. The detection rate of colorectal adenoma was significantly higher in the GP group than in the EGD negative group (16.7% vs 11.7%) (P<0.001). In the GP group, the detection rate of colorectal adenoma in the males of 45 to 49 years was significantly higher than the males of 40 to 44 years (26.7%, 28/105 vs. 14.6%, 15/103) (P=0.031), but was similar to the rates in the males of 50 to 54 years (18.8%, 29/154) and 55 to 59 years (26.3%, 41/156). However, the colorectal adenomas were less common in women of 40 to 44 years(7.6%, 10/132) and 45 to 49 years (11.2%, 21/187). Conclusions: The detection rate of asymptomatic colorectal adenoma in the population of 40 to 59 years was 3.6%. Male patients of 45 to 49 years having gastric polys with the average risk of CRC are a new target population for colonoscopy screening.