Abstract
BACKGROUND:
Colorectal polyps are the most important precursor lesions of colorectal cancer. Their epidemiological characteristics and risk factors exhibit substantial regional and population-based variations. Qinghai Province, located on the Qinghai–Tibet Plateau in China, is characterized by a unique hypoxic environment and a multi-ethnic population. However, large-scale epidemiological data on colorectal polyps in this region is limited.
OBJECTIVE:
To characterize the detection rate, temporal trends, demographic distribution, and risk factors for colorectal polyps in Qinghai Province.
DESIGN:
Retrospective study
SETTING:
A single tertiary medical center in Qinghai Province, China.
PATIENTS AND METHODS:
We enrolled 33059 patients who underwent colonoscopy at Qinghai University Affiliated Hospital (2021–2025). Data on demographics and endoscopic findings were collected. Temporal trends were analyzed using the linear-by-linear association LLA test, and independent risk factors were identified by binary logistic regression.
MAIN OUTCOME MEASURES:
Colorectal polyp detection rate and risk factors.
SAMPLE SIZE:
33059 patients
RESULTS:
The overall colorectal polyp detection rate was 31.82% (10519/33059), with a slight upward trend over the study period. Rates were significantly higher in males (39.01%) than females (24.04%) and increased sharply with age. Multivariable analysis identified male sex (OR=2.493, 95 %CI:2.106–2.950, P<.001), age 41–64 years (OR=2.535, 95% CI:2.056–3.125, P<.001), and age ≥65 years (OR=4.379, 95% CI:3.328–5.761, P<.001) as independent risk factors. Tibetan and Hui ethnicities were associated with lower risk compared with Han (OR=0.611, 95% CI:0.448–0.833, P=.002).
CONCLUSIONS:
Colorectal polyp detection is high and rising in Qinghai. Male sex and advanced age are major risk factors. Notably, Tibetan or Hui ethnicity appear as potential protective factors, offering new insights into genetic interactions that may inform region-specific screening strategies.
LIMITATIONS:
Single-center retrospective design, potential selection bias, lack of lifestyle and metabolic data.
Keywords: Colorectal polyps, epidemiology, risk factors, high altitude, ethnicity, colonoscopy
INTRODUCTION
Colorectal polyps, particularly adenomatous polyps, are the most important precursors for colorectal cancer. Adenomatous polyp detection and treatment are therefore crucial for prevention and reduction of colorectal cancer incidence and mortality.1 Colorectal polyp detection varies substantially in different populations and depends heavily on age, genetic factors, lifestyle and metabolic disorders worldwide.2 In a single centre study from Nepal, the overall polyp detection rate in those receiving a colonoscopy was 12.95%, with adenomas detected accounted for 43.61% of all polyps.3 A study from eastern China showed a polyp detection rate of 20% in young adults aged <45 years, among whom 47.6% had adenomas.4 Two meta-analyses have reported adenomatous polyp detection rates ranging from 23% to 30% among individuals aged 45–50 years, with prevalence increasing progressively with age.5,6
However, the limited epidemiological data available are largely derived from international studies or economically developed regions in eastern China. Consequently, substantial gaps remain in our understanding of colorectal polyps in Qinghai Province, a region distinguished by its unique geographical environment, lifestyle patterns, and ethnic diversity. Qinghai, located on the Qinghai–Tibet Plateau in the north-west of China, is characterized by its high altitude environment, multi-ethnic population, and distinct dietary patterns, particularly a high intake of protein and fat. These demographic and lifestyle characteristics differ markedly from those observed in lowland regions. All these factors may uniquely affect the health state of the colorectal mucosa and risk of polyp development. However, information on the prevalence and risk factors of colorectal polyps in Qinghai Province remains limited. Thus, research on trends and related risk factors for colorectal polyps in Qinghai are important for public health and clinical practice. The present study aims to present a systematic profile of colorectal polyp epidemiology in Qinghai by analyzing local colonoscopy data focused on age, sex and ethnicity. Findings may fill a data void and provide important information relevant to colorectal cancer screening and early detection policy in Qinghai.
PATIENTS AND METHODS
Setting and patients
This retrospective study was conducted at Qinghai University Affiliated Hospital from January 2021 to December 2025 and adhered to the principles cited in the Declaration of Helsinki. Waiver of consent was approved by the Ethics Committee of the Qinghai University Affiliated Hospital (P-SL-201958).
Inclusion exclusion criteria
Diagnostic criteria
Colorectal polyps were defined as any mucosal protrusion identified during colonoscopy and documented in the endoscopic report. Colorectal cancer was defined as any lesion described by the endoscopist as “cancer” or considered highly suspicious for malignancy based on endoscopic appearance. Inclusion criteria: (1) resident of Qinghai Province; (2) underwent first colonoscopy at our institute from January 2021 to December 2025, primarily for lower gastrointestinal symptoms and discomfort; (3) aged ≥18 years; (4) had an endoscopic report documenting “colonic polyp”, “rectal polyp” or “colorectal polyp”. Exclusion criteria: (1) history of colorectal cancer, inflammatory bowel disease, hereditary polyposis diseases; (2) previous colorectal resection; (3) colonoscopy performed solely for therapeutic intervention (endoscopic mucosal resection/endoscopic submucosal dissection) on previous lesions; (4) pregnant or lactating; (5) poor bowel preparation, incomplete examination (cecum not reached); (6) missing clinical or endoscopic data that precluded adequate evaluation.
Data collection
Demographic and clinical data, including patient name, sex, age, medical history, and colonoscopy findings, were retrieved from the hospital endoscopy imaging system and electronic medical records. Patients who satisfied all inclusion and exclusion criteria (n=33059) were enrolled in the study. For a subset of participants, additional data on ethnicity and residential altitude were collected to investigate potential differences in colorectal polyp detection rates across ethnic groups and altitude categories in Qinghai Province. Histopathological confirmation was not available for the majority of cases, as pathological data were not routinely linked to or extracted from the endoscopic database used for this retrospective analysis. Therefore, all reported lesions and detection rates were based on endoscopically visualized findings rather than histopathological diagnoses.
Colonoscopy examination
These colonoscopy examinations in our study were performed by experienced physicians in the hospital. Standard pre-operation bowel preparation was done before colonoscopy. Colonoscopy was done with a conventional electronic colonoscope under sedation or anesthesia, introducing the scope into the anus to complete transanal endoscopic progression of the examination to the rectum and the whole colon to the cecum and withdrawal of the colonoscope for an exhaustive and routine observation of the colon mucosa. All suspicious polyps or lesions were recorded (location and morphology) and biopsy was done at the discretion of the physician. The quality and completeness of examination (including cecal examination, withdrawal time ≥6 minutes), quality of bowel preparation (using the Boston Bowel Preparation Scale) were also taken into account in quality control.
Statistical analysis
Data analysis was performed using SPSS 22.0. Categorical variables were described as proportions (detection rates). Temporal trends were assessed using the linear-by-linear association (LLA) test and Spearman correlation analysis. Differences in polyp detection rates between groups were compared using the Chisquare test, with the partition method applied for multiple comparisons. Binary logistic regression analysis was conducted to identify risk factors for colorectal polyps. Variables with a P value <.05 in the univariate analysis were entered into the multivariate binary logistic regression model using the enter method. The results are presented as adjusted odds ratios (OR) with 95% confidence intervals (CI). Missing data for the variables included in the final model were handled using listwise deletion. A two-sided P<.05 was considered statistically significant.
RESULTS
Demographic characteristics
A total of 33059 patients were enrolled in this study, including 5629 in 2021, 4599 in 2022, 6009 in 2023, 7887 in 2024, and 8935 in 2025. The age ranged from 18 to 92 years, with a median of 53 (interquartile range, 44–60) years. Age stratification yielded 6608 patients aged 18–40 years, 21677 aged 41–64 years, and 4774 aged ≥65 years. There were 17174 males and 15,885 females. To investigate the influence of high-altitude hypoxic environments (defined as altitudes >2500 m according to Qinghai criteria7) and ethnicity on colorectal polyp detection rates, information on altitude of residence and ethnicity was collected for a subset of patients. A total of 2187 residents at high altitude (>2500 m) and 2187 residents at low altitude (≤2500 m) were included; ethnic distribution comprised 16179 Han, 2632 Tibetan, and 2414 Hui individuals.
Overall detection rate and temporal trends of colorectal polyps in Qinghai
The overall detection rate of colorectal polyps from 2021 to 2025 was 31.82% (10519/33059), with annual rates of 29.72% (1673/5629), 31.46% (1447/4599), 33.13% (1991/6009), 32.36% (2552/7887), and 31.96% (2856/8935), respectively. The temporal trend was statistically significant (LLA χ2=7.005, P=.008). Subgroup analysis by polyp location revealed overall detection rates of 26.54% (8775/33059) for colonic polyps, 8.64% (2856/33059) for rectal polyps, and 3.36% (1112/33059) for concurrent colonic and rectal polyps, each showing a modest upward trend with statistical significance. Annual and overall detection rates for each subtype are presented in Table 1.
Table 1.
Detection rate and trend changes of colorectal polyps in Qinghai from 2021 to 2025 (Detection number [Detection rate]).
| Classification | 2021 (n=5629) | 2022 (n=4599) | 2023 (n=6009) | 2024 (n=7887) | 2025 (n=8935) | Total (n=33059) | LLAX2 | P value | rs | P value |
|---|---|---|---|---|---|---|---|---|---|---|
| Colon polyps (%) | 1273 (24.4) | 1066 (26.3) | 1512 (28.2) | 1832 (26.8) | 1980 (26.6) | 8775 (26.5) | 6.549 | .01 | 0.012 | .030 |
| Rectal polyps (%) | 299 (7.1) | 239 (8.3) | 295 (8.0) | 436 (9.1) | 475 (9.8) | 2856 (8.6) | 35.49 | <.001 | 0.033 | <.001 |
| Colon polyps with rectal polyps (%) | 101 (1.8) | 142 (3.1) | 184 (3.1) | 284 (3.6) | 401 (4.5) | 1112 (3.4) | 75.925 | <.001 | 0.048 | <.001 |
| Colorectal polyps (%) | 1673 (29.7) | 1447 (31.5) | 1991 (33.1) | 2552 (32.4) | 2856 (32.0) | 10159 (31.8) | 7.005 | .008 | 0.013 | .022 |
LLA=linear-by-linear association, rs=spearman correlation coefficient; The detection rate of colon polyps = (Number of colon polyps + Number of colon polyps combined with rectal polyps) Total number; The detection rate of rectal polyps=(Number of rectal polyps + Number of colonic polyps combined with rectal polyps) / Total number; The detection rate of colorectal polyp =(Number of simple colonic polyps + Number of simple rectal polyps + Number of colonic polyps combined with rectal polyps) / Total number
Sex-specific detection rates and temporal trends
The overall detection rates were 39.01% (6700/17174) in males and 24.04% (3819/15885) in females. A modest upward trend was observed in males (LLA χ2=9.568, P=.002; rs= 0.021, P=.005), whereas no significant trend was noted in females (LLA χ2=1.650, P=.199). Annual rates by sex are shown in Table 2.
Table 2.
Detection rates and trend changes of colorectal polyps in different gender groups in Qinghai from 2021 to 2025 (Detection rate [%] [Detection number/Total number]).
| Year | Male | Female | Total |
|---|---|---|---|
| 2021 | 36.0 (1073/2979) | 22.6 (600/2650) | 29.7 (1673/5629) |
| 2022 | 38.2 (927/2429) | 24.0 (520/2170) | 31.5 (1447/4599) |
| 2023 | 40.5 (1285/3172) | 24.9 (706/2837) | 33.1 (1991/6009) |
| 2024 | 40.0 (1627/4067) | 24.2 (925/3820) | 32.4 (2552/7887) |
| 2025 | 39.5 (1788/4527) | 24.2 (1068/4408) | 32.0 (2856/8935) |
| Total | 39.0 (6700/17174) | 24.0 (3819/15885) | 31.8 (10519/33059) |
Age-specific detection rates and temporal trends
Stratified by age group (18–40, 41–64, and ≥65 years), the overall detection rates were 16.90% (1117/6608), 33.92% (7352/21677), and 42.94% (2050/4774), respectively. A modest upward trend was observed in the 41–64 years group (lLLA χ2=19.068, P<.001; rs=0.028, P<.001), whereas no significant trend was found in the 18–40 years group (LLA χ2=0.260, P=.610) or the ≥65 years group (LLA χ2=0.594, P=.441). Annual detection rates by age group are presented in Table 3.
Table 3.
Detection rates and trend changes of colorectal polyps in different age groups in Qinghai from 2021 to 2025 (Detection rate [%] [Detection number/Total number])
| Year | 18–40 years old | 41–64 years old | ≥65 years old | Total |
|---|---|---|---|---|
| 2021 | 15.7 (157/1001) | 31.2 (1200/3852) | 40.7 (316/776) | 29.7 (1673/5629) |
| 2022 | 17.9 (144/805) | 32.7 (1010/3092) | 41.7 (293/702) | 31.5 (1447/4599) |
| 2023 | 17.2 (191/1108) | 34.7 (1364/3934) | 45.1 (436/967) | 33.1 (1991/6009) |
| 2024 | 16.6 (275/1653) | 34.8 (1773/5097) | 44.3 (504/1137) | 32.4 (2552/7887) |
| 2025 | 17.1 (350/2041) | 35.2 (2005/5702) | 42.0 (501/1192) | 32.0 (2856/8935) |
| Total | 16.9 (1117/6608) | 33.9 (7352/21677) | 42.9 (2050/4774) | 31.8 (10519/33059) |
Factors associated with colorectal polyps
Analysis of factors associated with colorectal polyp detection revealed that males had a significantly higher detection rate than females (χ2=852.543, P<.001). Significant differences were observed across age groups (χ2=993.761, P<.001); post-hoc pairwise comparisons using the partition method indicated that the detection rate was highest in the ≥65 years group, followed by the 41–64 years and 18–40 years groups. Residents at high altitude (>2500 m) had a significantly lower detection rate than those at low altitude (≤2500 m) (χ2=42.192, P<.001). Detection rates varied significantly by ethnicity, with the highest rate in Han, followed by Hui and Tibetan (χ2=170.488, P<.001) (Table 4).
Table 4.
Analysis of influencing factors of colorectal polyps in Qinghai.
| Influencing factors | Total | Detection uumber (detection rate[%]) | χ2 value | P value |
|---|---|---|---|---|
| Gender | ||||
| Male | 17174 | 6700 (39.01) | 852.543 | <.001 |
| Female | 15885 | 3819 (24.04) | ||
| Age (years) | ||||
| 18–40 | 6608 | 1117 (16.90) | 993.761 | <.001 |
| 41–64 | 21677 | 7352 (33.92)a | ||
| ≥65 | 4774 | 2050 (42.94)ab | ||
| Altitude (m) | ||||
| >2500 | 2187 | 462 (21.12) | 42.192 | <.001 |
| ≤2500 | 2187 | 649 (29.68) | ||
| Ethnicity | ||||
| Han | 16179 | 5385 (33.28) | 170.488 | <.001 |
| Tibetan | 2632 | 558 (21.20)a | ||
| Hui | 2414 | 665 (27.55)ab |
Note:
Indicates statistical significance compared with the first group (P<.001)
Indicates statistical significance compared with the second group (P<.001).
Risk factors for colorectal polyps
A binary logistic regression model was constructed to identify risk factors for colorectal polyps, with sex, age, altitude of residence, and ethnicity as independent variables and the presence of colorectal polyps as the dependent variable. The results showed that male sex (OR=2.493, 95% CI: 2.106–2.950, P<.001), age 41–64 years (OR=2.535, 95% CI: 2.056–3.125, P<.001), and age ≥65 years (OR=4.379, 95% CI: 3.328–5.761, P<.001) were risk factors for colorectal polyps (Table 5). Compared with Han ethnicity, Tibetan and Hui ethnicities were associated with a lower risk (OR=0.611, 95% CI: 0.448–0.833, P=.002) (Table 5). In the univariate analysis, a higher altitude of residence showed a trend towards association with lower polyp detection, but this association was not sustained in the multivariate logistic regression model (Table 5).
Table 5.
Analysis of risk factors for colorectal polyps in Qinghai.
| Variable | OR value | 95% CI | P value |
|---|---|---|---|
| Gender (male) | 2.493 | 2.106–2.950 | <.001 |
| Age (41–64 years old) | 2.535 | 2.056–3.125 | <.001 |
| Age (≥65 years old) | 4.379 | 3.328–5.761 | <.001 |
| Altitude (>2500 m) | .976 | .703–1.355 | .884 |
| Ethnicity (Tibetan and Hui) | .611 | .448–0.833 | .002 |
CI=confidence interval
DISCUSSION
This study systematically characterized the epidemiological profile of colorectal polyps in Qinghai Province and investigated associated risk factors based on an analysis of 33059 colonoscopy examinations conducted between 2021 and 2025. The main findings are as follows: (1) the overall detection rate of colorectal polyps was 31.82%, with a modest upward trend observed during the study period; (2) male sex and advanced age (particularly ≥65 years) were identified as independent risk factors; (3) compared with the Han population, Tibetan and Hui ethnic groups exhibited a lower risk of colorectal polyps. These findings provide important local data for understanding the distribution and etiology of colorectal polyps in Qinghai and similar high-altitude regions.
Regarding the detection rate and temporal trends, the overall detection rate of colorectal polyps in Qinghai was 31.82%, with a statistically significant modest upward trend from 2021 to 2025. This trend may be attributable to multiple factors, including the gradual expansion of colonoscopy screening programs in the region, improvements in endoscopic diagnostic proficiency, increased health awareness among residents, and changes in the underlying disease burden.8 It is worth mentioning that the observed upward trend from 2021 to 2025 must be interpreted within the context of the COVID-19 pandemic. The initial years of our study period (2021–2022) likely reflect suppressed endoscopic activity due to pandemic restrictions and patient hesitancy, potentially leading to a backlog of higher-risk, symptomatic patients. The subsequent increase may partially represent a ‘rebound effect’ of normalized healthcare access and the resolution of postponed procedures, rather than a true secular increase in polyp prevalence. This ecological confounding is an unavoidable limitation of studying trends across this specific period and suggests caution in extrapolating the trend linearly into the future. Notably, detection rates for all subtypes (colonic polyps, rectal polyps, and concurrent lesions) exhibited a parallel modest increase, suggesting a general trend. Although histopathological subclassification of polyps was not performed in this study, adenomatous polyps are known to be the most important precursors of colorectal cancer. Thus, the observed increase in detection rates, while partly reflecting increased screening coverage, may also indicate a growing burden of precancerous lesions in the population, underscoring the importance of enhanced screening and surveillance in high-risk groups.9
Second, sex and age were reaffirmed as classic risk factors in this study. The detection rate of colorectal polyps was significantly higher in males (39.0%) than in females (24.0%), and an upward trend over time was observed only in males. Multivariable analysis further confirmed male sex as an independent risk factor, a finding consistent with most studies worldwide.10–12 Regarding age, this study clearly demonstrated a marked increase in polyp risk with advancing age: individuals aged 41–64 years had a 2.5-fold higher risk than those aged 18–40 years, and the risk increased to 4.4-fold in those aged ≥65 years. Advanced age is one of the most well-established and strongest risk factors for colorectal polyps and cancer.13,14 Our results align with an earlier study reporting that individuals over 50 years of age had a 3.2-fold higher risk of colonic polyps than younger individuals.15 This may be attributable to the cumulative effects of genetic and epigenetic damage over time, declining immune surveillance, and prolonged exposure to environmental risk factors.16,17
Third, about the location distribution of polyps, the detection rate of colonic polyps (26.5%) was far higher than that of rectal polyps (8.6%), indicating that the colon was more common for polyps in Qinghai. However, there is still a special clinical implication of rectal polyps in certain situations. For example, a study about delayed post-polypectomy bleeding (DPPB) found that rectal location was an important independent factor for the occurrence of DPPB.18 Another classic study found that the colorectal epithelial cell proliferation rate of patients with rectal polyps was higher than that of patients with colonic polyps.19 The clinical difference between polyps in different anatomical locations can reflect their different biological behaviour or pathological meaning, and should be noted in clinical practice. The present study did not find an association between the location of polyps and demographic data, an issue that needs further study.
Fourth, this study found that the Tibetan and Hui population had lower risk of colorectal polyps compared with the Han population. Ethnic differences often reflect a combination of features, such as background gene, living habits and ethnicity background. For example, the traditional diet of Tibetans is basically a diet high in protein, such as yak meat and dairy products, and highland barley with a low intake of fruit and vegetables. However, the precise impact of this dietary pattern on colorectal health remains unclear. Some studies have reported that higher fruit and vegetable intake is associated with lower colorectal epithelial cell proliferation rates,19 which appears to contradict the lower polyp risk observed in Tibetans, suggesting that other, stronger protective factors—such as genetic predisposition or gut microbiota—may be at play. Genetic factors are paramount; for example, in familial adenomatous polyposis (FAP), specific APC gene mutations are closely associated with disease phenotype, including rectal cancer risk.20 In the general population, distinct ethnic groups may also carry different susceptibility variants for colorectal cancer. Thus, the lower risk observed in Tibetan and Hui populations may stem from their unique genetic backgrounds and adaptive responses to the local environment and lifestyle. The observed ethnic disparities in colorectal polyps detection rate must be interpreted with caution. Lower rates among Tibetan and Hui populations could reflect several non-biological factors: a higher proportion of firsttime screeners (“screening-naïve” status) within these groups, cultural differences in symptom reporting or healthcare utilization, or variations in the prevalence of accepted risk factors (e.g., smoking, obesity) not captured in our data. While genetic protective factors cannot be ruled out, our study design cannot distinguish them from these powerful environmental and behavioral influences. Future studies should stratify indications for colonoscopy by ethnicity to evaluate for potential selection bias.
While an initial association was observed in univariate analysis, altitude was not an independent risk factor in our multivariate model. The observed trend may be confounded by other unmeasured factors correlated with altitude, such as population ethnicity, specific dietary patterns, or physical activity levels, which were not captured in our data. The observed association in univariate analysis between higher altitude and lower polyp detection rates warrants careful interpretation. As a single-center study, our ‘altitude’ variable is likely a strong surrogate for unmeasured confounders correlated with geographic region, including ethnic composition, traditional dietary patterns (e.g., lower processed meat intake), physical activity levels, and potentially differential healthcare-seeking behaviors. Without individual-level data on these lifestyle and socioeconomic factors, we cannot isolate a potential hypoxia effect. Therefore, this finding should be viewed as a hypothesis-generating ecological association that highlights a distinct epidemiological pattern in high-altitude populations, which merits future investigation with carefully collected confounder data.
Finally, several limitations of this study should be acknowledged. First, as a single-center retrospective study, selection bias may be present—for instance, the study population consisted predominantly of patients presenting with gastrointestinal symptoms, which may have led to an overestimation of the polyp detection rate relative to the general population. Second, detailed lifestyle data (e.g., smoking, alcohol consumption, dietary patterns, physical activity) and metabolic parameters (e.g., body mass index, blood glucose, lipids) were not available for all patients, despite being well-established risk or protective factors for colorectal polyps.21 For example, smoking has been significantly associated with colonic polyp development,15 and metabolic abnormalities represent important risk factors for gastrointestinal polyps regardless of obesity status.21 The absence of these data limited in-depth exploration of the mechanisms underlying the observed differences related to altitude and ethnicity. The inability to adjust for key lifestyle and socioeconomic confounders means our analysis of factors like altitude and ethnicity is susceptible to residual confounding, precluding causal inference. Third, the lack of histopathological classification for the detected polyps is a significant limitation. Without distinguishing adenomatous from non-adenomatous polyps, our analysis of ‘risk factors’ is applicable only to polyps in general and not specifically to precancerous adenomas. Consequently, the clinical implications of the identified factors (e.g., age, gender) are limited to predicting the likelihood of finding any polyp during colonoscopy, not necessarily a clinically significant one. A key strength of this study lies in its large sample size derived from multi-year, real-world clinical practice. Additionally, it provides unique epidemiological data on a geographically and ethnically diverse high-altitude population, which is currently underrepresented in the literature. Future prospective, multicenter studies with systematic collection of such data, along with community-based screening initiatives, are warranted to obtain more accurate epidemiological estimates.
In conclusion, this retrospective study demonstrates a modest upward trend in the detection of colorectal polyps over time. Although the lack of histopathological classification limits the ability to assess precancerous risk directly, the findings underscore the growing burden of colorectal polyps in this population. These results advocate for enhanced awareness and the establishment of systematic screening programs to facilitate early detection and management of colorectal polyps, with the aim of improving long-term clinical outcomes.
Funding Statement
Clinical Medicine Research Center for Digestive System Diseases of Qinghai Province x 2019-SF-L3 Key Discipline Project of Qinghai University Affiliated Hospital
Footnotes
CONFLICT OF INTEREST: None.
AUTHOR CONTRIBUTIONS
Jianan Tao: conceptualization, methodology, investigation, writing – original draft. Xuehong Wang: conceptualization, writing – review & editing, supervision. Shenghui Wei: investigation, manuscript – review & editing. Xiuzhen Zhao: investigation, tables – review & editing. All authors have read and approved the final manuscript.
DATA AVAILABILITY STATEMENT
The data used in this study is available from the corresponding author upon reasonable request.
FUNDING
This research received from Key Discipline Project of Qinghai University Affiliated Hospital and Clinical Medicine Research Center for Digestive System Diseases of Qinghai Province (2019-SF-L3).
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
The data used in this study is available from the corresponding author upon reasonable request.