Increased Prevalence of Colorectal Neoplasia in Korean Patients with Sporadic Duodenal Adenomas: A Case-Control Study (original) (raw)
Related papers
The Prevalence of Colorectal Adenomas in Asymptomatic Korean Men and Women
Cancer Epidemiology, Biomarkers & Prevention, 2014
Background: Colorectal cancer incidence is rapidly rising in many Asian countries, with rates approaching those of Western countries. This study aimed to evaluate the prevalence and trends of colorectal adenomas by age, sex, and risk strata in asymptomatic Koreans. Methods: Cross-sectional study of 19,372 consecutive participants aged 20 to 79 years undergoing screening colonoscopy at the Center for Health Promotion of the Samsung Medical Center in Korea from January 2006 to June 2009. Results: Among participants at average risk, those without a history of colorectal polyps or a family history of colorectal cancer, the prevalence of colorectal adenomas and advanced adenomas were 34.5% and 3.1%, respectively, in men and 20.0% and 1.6%, respectively, in women. The prevalence of adenomas increased with age in both men and women, with a more marked increase for advanced adenoma. Participants with a family history of colorectal cancer or with a history of colorectal polyps had significan...
Increased risk of colonic neoplasia in patients with sporadic duodenal adenoma
Gastroentérologie Clinique et Biologique, 2009
Background. -Recent studies have shown an increased risk of colorectal neoplasia in patients with duodenal neoplasia. The aim of this retrospective case-control study was to confirm this risk. Patients and methods. -Rate of colorectal neoplasia in 29 patients with one or more duodenal adenomas were compared with controls matched for gender and age, but without duodenal adenomas (one case to two controls). Patients with neoplasia of the ampulla, familial adenomatous polyposis or other known hereditary conditions of the digestive tract were excluded. Indications for upper and lower gastrointestinal endoscopy in controls were abdominal pain or changes in bowel habits. Controls with anemia or digestive bleeding were not included. Neoplastic lesions found at colonoscopy were classified as adenomas, advanced adenomas (size ≥ 10 mm, villous component, high-grade dysplasia), cancers and advanced neoplasia (cancers and advanced adenomas). Comparison between groups was by Fisher's exact test or Student's t test. Odds-ratios (OR) and 95% confidence intervals were calculated, if the difference was significant.
Gastroenterology, 2013
We investigated adenoma and colonoscopy characteristics that are associated with recurrent colorectal neoplasia based on data from communitybased surveillance practice. METHODS: We analyzed data of 2990 consecutive patients (55% male; mean age 61 years) newly diagnosed with adenomas from 1988 to 2002 at 10 hospitals throughout The Netherlands. Medical records were reviewed until December 1, 2008. We excluded patients with hereditary colorectal cancer (CRC) syndromes, a history of CRC, inflammatory bowel disease, or without surveillance data. We analyzed associations among adenoma number, size, grade of dysplasia, villous histology, and location with recurrence of advanced adenoma (AA) and nonadvanced adenoma (NAA). We performed a multivariable multinomial logistic regression analysis to estimate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: During the surveillance period, 203 (7%) patients were diagnosed with AA and 954 (32%) patients with NAA. The remaining 1833 (61%) patients had no adenomas during a median follow-up of 48 months. Factors associated with AA during the surveillance period included baseline number of adenomas (ORs ranging from 1.6 for 2 adenomas; 95% CI: 1.1Ϫ2.4 to 3.3 for Ն5 adenomas; 95% CI: 1.7Ϫ6.6), adenoma size Ն10 mm (OR ϭ 1.7; 95% CI: 1.2Ϫ2.3), villous histology (OR ϭ 2.0; 95% CI: 1.2Ϫ3.2), proximal location (OR ϭ 1.6; 95% CI: 1.2Ϫ2.3), insufficient bowel preparation (OR ϭ 3.4; 95% CI: 1.6Ϫ7.4), and only distal colonoscopy reach (OR ϭ 3.2; 95% CI: 1.2Ϫ8.5). Adenoma number had the greatest association with NAA. High-grade dysplasia was not associated with AA or NAA. CONCLUSIONS: Large size and number, villous histology, proximal location of adenomas, insufficient bowel preparation, and poor colonoscopy reach were associated with detection of AA during surveillance based on data from community-based practice. These characteristics should be used jointly to develop surveillance policies for adenoma patients.
Journal of Gastroenterology and Hepatology, 2010
A left-to-right shift of colorectal cancer (CRC) has been reported in Western studies. However, few Asian studies have investigated the anatomic distribution of colorectal adenoma and CRC. We aimed to describe the time trends in the distribution of colorectal adenoma and CRC in a Chinese population. Methods: A colonoscopy database was reviewed, and all consecutive patients with lower gastrointestinal symptoms who underwent colonoscopy from 1998 to 2009 were identified. Data, including patients' sex, age, symptoms, and the number and anatomic locations of colorectal adenoma and CRC, were documented. Results: A total of 11 025 patients were included in the final analysis; 1012 and 363 patients were diagnosed with colorectal adenoma and CRC, respectively. Overall, there were more distal than proximal adenomas (54.4% vs 37.9%), and the proportion of proximal adenomas remained stable from 1998-2006 to 2007-2009 (38.2% vs 37.6%). Similarly, there were more distal than proximal CRC (56.5% vs 42.4%), and the proportion of proximal CRC declined from 45.8% in 1998-2006 to 38.4% in 2007-2009. Colorectal adenoma and CRC were equally distributed among both sexes. For elderly patients (> 50 years), there was a non-significant trend towards more proximal adenoma and CRC. Conclusions: The present study suggests no distal-to-proximal shift of colorectal adenoma and CRC among the Chinese population in Shanghai over the past 12 years. The distribution pattern of colorectal adenoma and CRC of Chinese patients is different from that of Western patients, who had more colorectal lesions located in the distal part.
Background: Colorectal cancer is currently the third most common cancer in Indonesia, yet colonoscopy - the most accepted mode of screening to date - is not done routinely and national data are still lacking. Objective: To determine the detection rate of colorectal cancers and adenomas in unselected patients undergoing colonoscopy for various large bowel symptoms at the Digestive Disease and GI Oncology Centre, Medistra Hospital in Jakarta, Indonesia. Materials and Methods: Colonoscopy data from January 2009 to December 2012 were reviewed. New patients referred for colonoscopy were included. Data collected were patient demographic and significant colonoscopy findings such as the presence of hemorrhoids, colonic polyps, colonic diverticula, inflammation, and tumor mass. Histopathological data were obtained for specimens taken by biopsy. Associations between categorical variables were analyzed using chi-square test, while mean differences were tested using the t-test. Results: A total of, 1659 cases were included in this study, 889 (53.6%) of them being men. Polyps or masses were found in 495 (29.8%) patients while malignancy was confirmed in 74 (4.5%). Patients with a polyp or mass were significantly older (60.2 vs 50.8 years; p<0.001; t-test) and their presence was significantly associated with male gender (35.0% vs 23.9%; prevalent ratio [PR] 1.71; 95% confidence interval [CI] 1.38-2.12; p<0.001) and age >50 years (39.6% vs 16.6%; PR 3.29; 95% CI 2.59-4.12; p<0.001). Neoplastic lesions was found in 257 (16.1%), comprising 180 (11.3%) adenomas, 10 (0.6%) in situ carcinomas, and 67 (4.2%) carcinomas. Conclusions: Polyps or masses were found in 30% of colonoscopy patients and malignancies in 16.1%. These figures do not represent the nation-wide demographic status of colorectal cancer, but may reflect a potentially increasing major health problem with colorectal cancer in Indonesia.
Risk of colorectal adenomas in a multiethnic Asian patient population: Race does not matter
Journal of Gastroenterology and Hepatology, 2005
Background: Ethnic differences have been reported for colorectal polyps and large bowel cancer; although the supporting data is weak and insufficient to draw firm conclusions. Aim: We undertook this study to determine whether such racial disparity in colorectal adenomas exists in an ethnically mixed non-migrant population. The prevalence, histology and distribution of colonic polyps were documented as well as other known risk factors for colorectal malignancy. Methods: In this prospective cross-sectional study, 311 consecutive referred and self-referred multiracial patients attending for colonoscopy over a 41-month period in a private endoscopy center were recruited. The mean age of the study population was 51.8 ± 14 years (range 16-91). The male to female ratio was 1.1 and an ethnic breakdown as follows: 87 Malays, 115 Chinese and 109 Indians. Results: Sixty-three adenomas were recorded in 36 patients: six Malays, 19 Chinese and 11 Indians. Of these adenomas, 59 were polypoid, three flat and one depressed. The majority of adenomas 42/63 (67%) were distal to the splenic flexure as were all (10/10) the Duke's A carcinomas and 6/8 (75%) of the advanced cancers. Patients with adenoma(s) compared with those without (controls) were significantly older (P = 0.005), more likely to have a family history of colorectal cancer (P = 0.005), and showed a trend towards significance for ethnic group (P = 0.09) on univariate analysis. Using logistic regression analysis, only family history (P = 0.05) and age ≥ 50 years (P = 0.011) were found to be significantly associated with adenomas. Conclusion: Risk factors for colonic adenoma(s) in our cohort of symptomatic multiethnic patients attending for colonoscopy do not seem to differ from those reported elsewhere and, in particular, race does not appear to be a factor.