Clinicopathological Characteristics and Synchronous Lesions in Colorectal Cancer: A Single-Center Retrospective Colonoscopy Study

<b>Background/Objectives:</b> Colorectal cancer (CRC) is a major global health concern, with rising incidence across age groups. Early detection via colonoscopy and identification of precancerous polyps are crucial for prevention and improved outcomes. The objectives were to evaluate the epidemiology, anatomical distribution, morphology, and histopathology of CRC, and its association with synchronous colorectal polyps. <b>Methods:</b> In 2023, a retrospective study was conducted on 1973 patients undergoing colonoscopy due to symptoms like blood in the stool, changes in bowel habits, abdominal pain, weight loss, anemia, or as CRC follow-up. Complete colonoscopies were performed, and suspicious lesions were biopsied or resected for histological evaluation. Statistical analysis was performed using SPSS 11.0. <b>Results:</b> CRC was diagnosed in 78 patients (3.95%), with a male predominance (70.51%, <i>p</i> < 0.05) and a mean age of 65.1 ± 8.9 years. The most affected age group was 61-70 years (43.58%). Tumors were most commonly located in the rectum (32.05%) and sigmoid colon (26.92%). Polypoid morphology was observed in 67.95% of cases. Adenocarcinoma was the predominant histological type (93.59%), followed by mucinous adenocarcinoma (6.41%), with significant differences between right and left colon (<i>p</i> < 0.001). Synchronous polyps were detected in 47.43% of CRC cases, primarily adenomas (60.22%). In 37.84%, the tumor and polyp were in the same colon segment. Men had a higher rate of synchronous polyps than women (<i>p</i> < 0.05). <b>Conclusions:</b> CRC is more common in older males and typically affects the rectosigmoid region. Adenocarcinoma is the leading type. Nearly half of patients had synchronous adenomas, highlighting the importance of full colonoscopy for early CRC detection and prevention.