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Journal of Peking University (Health Sciences) ›› 2024, Vol. 56 ›› Issue (5): 815-819. doi: 10.19723/j.issn.1671-167X.2024.05.010

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Epidemiological characteristics of hemorrhoids in a healthy physical examination population in China

Chenghua GUO1, Xiaoyu CHE1, Zhi LIN1, Shan CAI1, Guozhen LIU2, Lang PAN3, Jun LV1,3,4, Liming LI1,3,4, Sailimai MAN5, Bo WANG5,*(), Canqing YU1,3,4,*()   

  1. 1. Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
    2. Beijing Institute of Big Data Research & PKU Healthcare IT Company Big Data Laboratory, Beijing 100080, China
    3. Peking University Center for Public Health and Epidemic Preparedness Response, Beijing 100191, China
    4. Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
    5. Mei-nian Public Health Research Institute, Peking University Health Science Center, Beijing 100191, China
  • Received:2021-02-28 Online:2024-10-18 Published:2024-10-16
  • Contact: Bo WANG, Canqing YU E-mail:paul@meinianresearch.com;yucanqing@pku.edu.cn
  • Supported by:
    Supported by 2020 Peking University School of Public Health Health Science Center Students' Innovation Training Program

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Abstract:

Objective: To describe the epidemiological distribution of hemorrhoids in a physical examination population in China, which could provide evidence for precision prevention and early intervention of hemorrhoids. Methods: Chinese subjects over 18 years of age who underwent a physical examination in a nationwide chain of physical examination centers in 2018 were studied in a cross-sectional design, which collected information by a questionnaire and physical examination results from each subject. The epidemiological distribution of hemorrhoids was described using Logistic models. The gender-, age-, and region-detection rates of hemorrhoids were standardized to the Sixth National Population Census of the People's Republic of China (2010). Results: A total of 2 940 295 adult subjects were included in the study, of whom the average age was (41.7±14.0) years, and 52.6% were females. The standardized detection rate of hemorrhoids was higher for females (43.7%) than that for males (17.7%; P < 0.001) in this study. In the females, the age distribution of hemorrhoids was inverted U-shaped, with the highest standardized detection rate of hemorrhoids in the age group of 30-39 years (63.5%). In the males, the standardized detection rate of hemorrhoids increased along with age, with the highest percentage of 17.2% in the age group of 50-59 years, and the standardized detection rate of hemorrhoids in the age group of 60 and above decreased slightly (P < 0.001 for trend test). The participants with hypertension had a higher standardized detection rate of hemorrhoids than those with normal blood pressure in both males and females (P < 0.001). The standardized detection rate of hemorrhoids showed a positive correlation with body mass index (P < 0.001 for trend test in males). Conclusion: The detection rate of hemorrhoids varied to gender, age, obesity, and hypertension status, which could help to identify the risk factors and the high-risk sub-groups, and hence to strengthen health education and early detection accordingly, which could eventually reduce the incidence of hemorrhoids and improve the quality of life and health in the Chinese population. This study was conducted in a physical examination population, and the conclusions of this study should be extrapolated with caution.

Key words: Hemorrhoid, Physical examination, Detection rate

CLC Number: 

  • R181.2

Table 1

Age and regional distribution characteristics of study participants"

ItemsMale Female
n % n %
Age group/years
  18-29 344 952 11.7 327 775 11.2
  30-39 378 289 12.9 408 239 13.9
  40-49 262 811 8.9 326 106 11.1
  50-59 235 372 8.0 289 863 9.9
  60-69 125 337 4.3 153 567 5.2
  70- 46 168 1.6 41 816 1.4
Region of China
  North 190 821 13.7 162 330 10.5
  Northeast 36 078 2.6 63 415 4.1
  East 616 890 44.3 768 956 49.7
  Central 86 196 6.2 84 692 5.5
  South 195 183 14.0 225 644 14.6
  Southwest 93 361 6.7 99 292 6.4
  Northwest 174 400 12.5 143 037 9.2
Total 1 392 929 47.4 1 547 366 52.6

Table 2

Detection rate of hemorrhoids in physical examination population over 18 years in China"

Items Male Female
Crude rate/%(95%CI) Standardized rate/%(95%CI) Crude rate/%(95%CI) Standardized rate/%(95%CI)
Age group/years
  18-29 9.1 (7.5-10.6) 7.3 (5.8- 8.8) 32.2 (27.5-36.9) 50.6 (32.2-68.9)
  30-39 17.3 (14.8-19.7) 13.9 (11.6-16.3) 47.3 (42.1-52.4) 63.5 (45.5-81.4)
  40-49 22.7 (19.8-25.7) 16.6 (13.3-19.8) 51.1 (46.1-56.0) 62.6 (40.7-84.4)
  50-59 24.8 (21.7-27.8) 17.2 (13.1-21.3) 47.7 (43.0-52.4) 56.2 (32.3-80.0)
  60-69 24.9 (21.5-28.3) 14.9 (10.9-18.8) 44.8 (39.2-50.3) 50.8 (27.3-74.2)
  70- 26.7 (22.6-30.9) 16.6 (9.5-23.6) 47.7 (39.4-56.1) 45.0 (17.3-72.7)
Region of China
  North 20.7 (13.6-27.9) 14.8 (7.5-22.2) 40.6 (28.9-52.4) 22.4 (＜0.1-47.2)
  Northeast 16.1 (7.4-24.7) 16.5 (7.3-25.6) 27.0 (19.0-34.9) 25.1 (20.6-29.5)
  East 19.1 (15.4-22.8) 18.0 (14.6-21.3) 49.3 (41.5-57.1) 39.5 (20.0-59.0)
  Central 31.7 (24.6-38.7) 9.8 (7.0-12.7) 47.2 (38.0-56.4) 53.1 (45.0-61.2)
  South 19.0 (15.3-22.7) 17.0 (13.0-21.0) 46.3 (39.5-53.0) 50.4 (42.6-58.2)
  Southwest 22.3 (15.2-29.4) 21.1 (13.8-28.5) 40.5 (30.6-50.5) 45.5 (37.0-54.0)
  Northwest 5.8 (2.9- 8.6) 4.1 (＜0.1- 9.5) 31.4 (12.0-50.9) 9.5 (＜0.1-26.2)
Total 18.5 (16.0-21.0) 17.7 (14.3-21.1) 44.7 (40.0-49.5) 43.7 (30.2-57.2)

Table 3

The relationship of BMI and hypertension status with detection rates of hemorrhoids in the physical examination population over 18 years in China"

ItemsMale Female
Crude rate/%(95%CI) Standardized rate/%(95%CI) OR(95%CI) Crude rate/%(95%CI) Standardized rate/%(95%CI) OR(95%CI)
BMI
  Underweight 10.0 (8.2 -11.7) 13.7 (19.9-17.5) 0.73 (0.70-0.75) 35.0 (30.6-39.5) 38.9 (28.0-49.9) 0.79 (0.78-0.81)
  Normal weight 17.0 (14.7-19.4) 17.0 (13.7-20.3) 1.00 45.2 (40.4-50.0) 45.8 (34.8-56.9) 1.00
  Overweight 20.3 (17.6-23.0) 18.1 (14.6-21.5) 1.10 (1.08-1.11) 46.3 (41.4-51.2) 43.2 (28.1-58.3) 0.98 (0.97-0.98)
  Obesity 19.5 (16.8-22.2) 18.7 (15.3-22.0) 1.09 (1.08-1.10) 43.5 (38.4-48.7) 38.4 (20.8-56.0) 0.89 (0.88-0.90)
Hypertension
  No 17.2 (14.9-19.6) 17.6 (14.4-20.8) 1.00 44.0 (39.1-48.9) 43.4 (30.7-56.0) 1.00
  Yes 21.1 (18.2-23.9) 18.1 (14.3-21.9) 1.02 (1.01-1.03) 45.4 (39.6-51.2) 44.8 (27.9-61.6) 1.03 (1.02-1.04)
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