我们报告了北爱尔兰大肠癌筛查计划基于病理学所得结果的头10年的病理学发现，呈现了病理诊断和临床病理特征的概要数据和趋势。自2010年开始至2021年的筛查计划全面性息肉级别病理数据库中分析了数据，共有9800名个体进行了13,472次内窥镜检查，产生了25,967份病理标本和32,119个诊断。指标标本诊断（4.1%）和指标结肠镜检查（10.4%）共诊断出1020名个体（其中25人患有同步性癌症）的1045例结直肠癌（另有13例指标癌症是通过计算机断层扫描结肠造影鉴定的），其中65.3%的癌症诊断发生在男性，41.7%为I期，23.1%为II期，25.8%为III期，1.8%为IV期（7.6%未分期）。在局限性切除标本中，诊断出233例pT1癌症，其中79例（33.9%）进行了补充手术。10年趋势显示，指标结肠镜检查中诊断出癌症（第1年占14.7%，第11年仅占4.8%）或复杂结直肠息肉的比例呈稳定下降；在研究时间范围结束时，关于切平型锯齿状病变的诊断呈强烈上升趋势，并超过了非增生性息肉的比例（8.7%相比于8.5%）。在人群结直肠癌筛查计划的头10年中，“真实世界”的病理学数据显示了相继筛查轮次后癌症和复杂结直肠息肉诊断减少的成功。与锯齿状息肉诊断相关的有趣趋势也很明显，可能与病理学家和内窥镜医生的行为有关。 参考文献：© 2023 作者。由约翰威利与儿子有限公司出版的《组织病理学》。

We report pathology findings from the first 10 years of the faecal-occult blood-based Northern Ireland Bowel Cancer Screening Programme, presenting summary data and trends in pathology diagnoses and clinicopathological features of screen-detected cancers.Data were analysed from a comprehensive polyp-level pathology database representing all endoscopy specimens from programme inception in 2010 until 2021. A total of 9800 individuals underwent 13 472 endoscopy procedures, yielding 25 967 pathology specimens and 32 119 diagnoses. Index specimen diagnoses (4.1%) and index colonoscopies (10.4%) yielded a diagnosis of colorectal cancer, representing 1045 cancers from 1020 individuals (25 with synchronous cancers). A further 13 index cancers were identified via computed tomography colonography; 65.3% of cancer diagnoses were in males; 41.7% were stage I, 23.1% stage II, 25.8% stage III and 1.8% stage IV (7.6% unstaged). Of 233 pT1 cancers diagnosed within local excision specimens, 79 (33.9%) had completion surgery. Ten-year trends showed a steady decline in the proportion of index colonoscopies that yielded a diagnosis of cancer (14.7% in year 1; 4.8% in year 11) or advanced colorectal polyp. There was a strong upward trend in diagnoses of sessile serrated lesions, which overtook hyperplastic polyps in proportions of total index diagnoses by the end of the study time-frame (8.7% compared to 8.5%).Over the first 10 years of a population colorectal cancer screening programme, 'real world' pathology data demonstrate success in the form of reduced diagnoses of cancer and advanced colorectal polyp with passage of successive screening rounds. Interesting trends with respect to serrated polyp diagnoses are also evident, probably related to pathologist and endoscopist behaviour.© 2023 The Authors. Histopathology published by John Wiley & Sons Ltd.