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Tanadi C, Tandarto K, Stella MM, Sutanto KW, Steffanus M, Tenggara R, Bestari MB. Colorectal cancer screening guidelines for average-risk and high-risk individuals: A systematic review. ROMANIAN JOURNAL OF INTERNAL MEDICINE = REVUE ROUMAINE DE MEDECINE INTERNE 2024; 62:101-123. [PMID: 38153878 DOI: 10.2478/rjim-2023-0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Indexed: 12/30/2023]
Abstract
AIMS This review aims to summarize the different colorectal cancer guidelines for average-risk and high-risk individuals from various countries. METHODS A comprehensive literature search regarding guidelines, consensus recommendations, or position statements about colorectal cancer screening published within the last 10 years (1st January 2012 to 27th August 2022), was performed at EBSCOhost, JSTOR, PubMed, ProQuest, SAGE, and ScienceDirect. RESULTS A total of 18 guidelines were included in this review. Most guidelines recommended screening between 45 and 75 years for average-risk individuals. Recommendations regarding colorectal cancer screening in high-risk individuals were more varied and depended on the risk factor. For high-risk individuals with a positive family history of colorectal cancer or advanced colorectal polyp, screening should begin at age 40. Some frequently suggested screening modalities in order of frequency are colonoscopy, FIT, and CTC. Furthermore, several screening intervals were suggested, including colonoscopy every 10 years for average-risk and every 5-10 years for high-risk individuals, FIT annually in average-risk and every 1-2 years in high-risk individuals, and CTC every five years for all individuals. CONCLUSION All individuals with average-risk should undergo colorectal cancer screening between 45 and 75. Meanwhile, individuals with higher risks, such as those with a positive family history, should begin screening at age 40. Several recommended screening modalities were suggested, including colonoscopy every 10 years in average-risk and every 5-10 years in high-risk, FIT annually in average-risk and every 1-2 years in high-risk, and CTC every five years.
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Affiliation(s)
- Caroline Tanadi
- 1Medical Profession Study Program, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Kevin Tandarto
- 2Department of Internal Medicine, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Maureen Miracle Stella
- 1Medical Profession Study Program, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Kenny Wijaya Sutanto
- 1Medical Profession Study Program, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Mario Steffanus
- 2Department of Internal Medicine, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Riki Tenggara
- 2Department of Internal Medicine, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
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Jeong SJ, Lee J, Kim E, Hwang JS, Lee J, Choi JH, Heo NY, Park J, Park SH, Kim TO, Park YE. Prevalence and risk of colorectal polyps among the Korean population under 50 years. Medicine (Baltimore) 2022; 101:e29493. [PMID: 35801765 PMCID: PMC9259151 DOI: 10.1097/md.0000000000029493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Colorectal cancer is a common cancer; generally, adults aged ≥ 50 years are screened using stool occult blood tests and colonoscopy. However, colorectal adenoma and cancer have been found in patients under the aged of 50, and studies on characteristics and risk factors in young patients are lacking. We evaluated the prevalence and risk factors of colorectal adenoma and cancer in young adults aged under 50 years. We retrospectively analyzed 570 individuals aged under 50 years who underwent colonoscopy at the Haeundae Paik Hospital, Korea, from January to June 2018. Logistic regression model was used to identify the risk factors for colorectal adenoma and colorectal cancer. The prevalence of colorectal adenoma in group of 19-29 years was 3.2% (1 of 31), 30-39 years was 13.8% (30 of 217) and in the group of 40-49 years was 21.1% (68 of 322) (P = .009). In multivariable analysis, age over 45 years (adjusted odds ratio [OR], 1.941; 95% confidence interval [CI], 1.187-3.172; P = .008) and male sex (adjusted OR, 1.711; 95% CI, 1.044-2.806; P = .033) were independent risk factors for colorectal neoplasia including cancer. The prevalence of colorectal adenoma increases as the age increased in young adults under 50 years of age, especially after the age of 45 years, the risk of colorectal neoplasia increases; hence, early screening should be considered before the age of 50 years.
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Affiliation(s)
- Su Jin Jeong
- Division of Gastroenterology, Department of Internal Medicine, Inje University College of Medicine, Haeundae Paik Hospital, Busan, Republic of Korea
| | - Jinho Lee
- Division of Gastroenterology, Department of Internal Medicine, Inje University College of Medicine, Haeundae Paik Hospital, Busan, Republic of Korea
| | - Eunju Kim
- Division of Gastroenterology, Department of Internal Medicine, Inje University College of Medicine, Haeundae Paik Hospital, Busan, Republic of Korea
| | - Jun Seong Hwang
- Division of Gastroenterology, Department of Internal Medicine, Inje University College of Medicine, Haeundae Paik Hospital, Busan, Republic of Korea
| | - Jin Lee
- Division of Gastroenterology, Department of Internal Medicine, Inje University College of Medicine, Haeundae Paik Hospital, Busan, Republic of Korea
| | - Joon Hyuk Choi
- Division of Gastroenterology, Department of Internal Medicine, Inje University College of Medicine, Haeundae Paik Hospital, Busan, Republic of Korea
| | - Nae-Yun Heo
- Division of Gastroenterology, Department of Internal Medicine, Inje University College of Medicine, Haeundae Paik Hospital, Busan, Republic of Korea
| | - Jongha Park
- Division of Gastroenterology, Department of Internal Medicine, Inje University College of Medicine, Haeundae Paik Hospital, Busan, Republic of Korea
| | - Seung Ha Park
- Division of Gastroenterology, Department of Internal Medicine, Inje University College of Medicine, Haeundae Paik Hospital, Busan, Republic of Korea
| | - Tae Oh Kim
- Division of Gastroenterology, Department of Internal Medicine, Inje University College of Medicine, Haeundae Paik Hospital, Busan, Republic of Korea
| | - Yong Eun Park
- Division of Gastroenterology, Department of Internal Medicine, Inje University College of Medicine, Haeundae Paik Hospital, Busan, Republic of Korea
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Mahanani MR, Kaucher S, Kajüter H, Holleczek B, Becher H, Winkler V. Colorectal Cancer among Resettlers from the Former Soviet Union and in the General German Population: Clinical and Pathological Characteristics and Trends. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094547. [PMID: 33922962 PMCID: PMC8123280 DOI: 10.3390/ijerph18094547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 04/01/2021] [Accepted: 04/23/2021] [Indexed: 01/13/2023]
Abstract
This study examined time trends and clinical and pathological characteristics of colorectal cancer (CRC) among ethnic German migrants from the Former Soviet Union (resettlers) and the general German population. Incidence data from two population-based cancer registries were used to analyze CRC as age-standardized rates (ASRs) over time. The respective general populations and resettler cohorts were used to calculate standardized incidence ratios (SIRs) by time-period (before and after the introduction of screening colonoscopy in 2002), tumor location, histologic type, grade, and stage at diagnosis. Additionally, SIRs were modeled with Poisson regression to depict time trends. During the study period from 1990 to 2013, the general populations showed a yearly increase of ASR, but for age above 55, truncated ASR started to decline after 2002. Among resettlers, 229 CRC cases were observed, resulting in a lowered incidence for all clinical and pathological characteristics compared to the general population (overall SIR: 0.78, 95% CI 0.68–0.89). Regression analysis revealed an increasing SIR trend after 2002. Population-wide CRC incidence decreases after the introduction of screening colonoscopy. In contrast the lowered CRC incidence among resettlers is attenuating to the general population after 2002, suggesting that resettlers do not benefit equally from screening colonoscopy.
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Affiliation(s)
- Melani Ratih Mahanani
- Epidemiology of Transition, Heidelberg Institute of Global Health, University Hospital Heidelberg, 69120 Heidelberg, Germany; (M.R.M.); (S.K.)
| | - Simone Kaucher
- Epidemiology of Transition, Heidelberg Institute of Global Health, University Hospital Heidelberg, 69120 Heidelberg, Germany; (M.R.M.); (S.K.)
| | | | | | - Heiko Becher
- Institute for Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany;
| | - Volker Winkler
- Epidemiology of Transition, Heidelberg Institute of Global Health, University Hospital Heidelberg, 69120 Heidelberg, Germany; (M.R.M.); (S.K.)
- Correspondence:
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Park CH, Jung YS, Kim NH, Park JH, Park DI, Sohn CI. Optimization of the surveillance strategy in patients with colorectal adenomas: A combination of clinical parameters and index colonoscopy findings. J Gastroenterol Hepatol 2021; 36:974-982. [PMID: 32869895 DOI: 10.1111/jgh.15237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 06/25/2020] [Accepted: 08/25/2020] [Indexed: 12/09/2022]
Abstract
BACKGROUND AND AIM In addition to index colonoscopy findings, demographic parameters including age are associated with the risk of metachronous advanced colorectal neoplasia. Here, we aimed to develop a risk scoring model for predicting advanced colorectal neoplasia (ACRN) during surveillance using a combination of clinical factors and index colonoscopy findings. METHODS Patients who underwent the removal of one or more adenomas and surveillance colonoscopy were included. A risk scoring model for ACRN was developed using the Cox proportional hazard model. Surveillance interval was determined as a time point exceeding 4% of the cumulative ACRN incidence in each risk group. RESULTS Of 9591 participants, 4725 and 4866 were randomly allocated to the derivation and validation cohorts, respectively. Age, abdominal obesity, advanced adenoma, and ≥ 3 adenomas at index colonoscopy were identified as risk factors for metachronous ACRN. Based on the regression coefficients, point scores were assigned as follows: age, 1 point (per 1 year); abdominal obesity, 10 points; advanced adenoma, 10 points; and ≥ 3 adenomas, 15 points. Patients were classified into high-risk (≥ 80 points), moderate-risk (50-79 points), and low-risk (30-49 points) groups. In the validation cohort, the high-risk and moderate-risk groups showed a higher risk of ACRN than the low-risk group (hazard ratio [95% confidence interval]: 7.11 [4.10-12.32] and 1.58 [1.09-2.30], respectively). Two-, 4-, and 5-year surveillance intervals were recommended for the high-risk, moderate-risk, and low-risk groups, respectively. CONCLUSIONS Our proposed model may facilitate effective risk stratification of ACRN during surveillance and the determination of appropriate surveillance intervals.
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Affiliation(s)
- Chan Hyuk Park
- Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
| | - Yoon Suk Jung
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Nam Hee Kim
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung Ho Park
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong Il Park
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chong Il Sohn
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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Jung YS, Kim NH, Yang HJ, Park SK, Park JH, Park DI, Sohn CI. Association between waist circumference and risk of colorectal neoplasia in normal-weight adults. J Gastroenterol Hepatol 2020; 35:43-49. [PMID: 31245873 DOI: 10.1111/jgh.14767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 06/13/2019] [Accepted: 06/18/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIM Abdominal obesity, measured using waist circumference (WC), is associated with the colorectal neoplasia (CRN) risk. We examined whether WC is associated with the CRN risk even in normal-weight individuals. METHODS A cross-sectional study was performed on asymptomatic normal-weight (body mass index 18.5-23 kg/m2 ) individuals who underwent colonoscopy as health checkups. RESULTS Of 63 057 examinees, 30 498 were men (mean age, 41.1 years) and 32 559 were women (mean age, 41.7 years). The prevalence of overall CRN in WC quartiles 1, 2, 3, and 4 was 14.2%, 15.5%, 15.5%, and 18.7%, respectively, in men and 7.4%, 8.9%, 9.4%, and 11.5%, respectively, in women. The prevalence of advanced CRN (ACRN) in WC quartiles 1, 2, 3, and 4 was 1.5%, 1.3%, 1.6%, and 2.1%, respectively, in men and 1.0%, 1.3%, 1.2%, and 1.3%, respectively, in women. Among men, the overall CRN risk in quartile 4 (> 82 cm) was higher than that in quartiles 1, 2, and 3 (adjusted odds ratio, OR [95% confidence interval, CI], 1.22 [1.11-1.34], 1.12 [1.05-1.23], and 1.18 [1.07-1.29], respectively); the ACRN risk in quartile 4 was also higher than that in quartiles 1, 2, and 3 (adjusted OR [95% CI], 1.41 [1.09-1.81], 1.56 [1.19-2.03], and 1.50 [1.16-1.94], respectively). Among women, the overall CRN risk in quartile 4 (> 77 cm) was higher than that in quartiles 1 and 3; the ACRN risk was not different among all groups. CONCLUSIONS Even with a normal weight, a large WC was associated with the CRN risk, especially with the ACRN risk in men.
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Affiliation(s)
- Yoon Suk Jung
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Nam Hee Kim
- Preventive Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyo-Joon Yang
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Soo-Kyung Park
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung Ho Park
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong Il Park
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chong Il Sohn
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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Risk of Developing Metachronous Advanced Colorectal Neoplasia After Polypectomy in Patients With Multiple Diminutive or Small Adenomas. Am J Gastroenterol 2019; 114:1657-1664. [PMID: 31211708 DOI: 10.14309/ajg.0000000000000296] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Current post-polypectomy guidelines recommend a 3-year surveillance interval for ≥3 nonadvanced adenomas (NAAs) without discrimination between diminutive (1-5 mm) and small (6-9 mm) adenomas. We compared the risk of metachronous advanced colorectal neoplasia (ACRN) among these groups. METHODS We studied 9,733 patients who underwent ≥1 adenoma removal and follow-up colonoscopic surveillance. Patients were classified based on baseline adenoma characteristics: group 1, 1-2 NAAs (n = 8,051); group 2, ≥3 diminutive NAAs (n = 293); group 3, ≥3 small NAAs (n = 258); and group 4, advanced adenomas (AAs) (n = 1,131). RESULTS The mean age of the study population was 45.8 ± 8.2 years. In group 4, most patients (94.5%) had 1 AA. The 3- and 5-year cumulative incidence rates of metachronous ACRN in groups 1, 2, 3, and 4 were 0.9%, 2.8%, 3.5%, and 4.0% and 3.1%, 10.7%, 15.1%, and 8.5%, respectively. Groups 2, 3, and 4 had a higher risk of metachronous ACRN than group 1. Compared with those for group 1, adjusted hazard ratios (95% confidence interval) for metachronous ACRN were 2.07 (1.16-3.68), 3.29 (1.94-5.56), and 2.73 (2.00-3.72) for groups 2, 3, and 4, respectively. However, this relationship was statistically insignificant between groups 2, 3, and 4. Compared with those for group 2, adjusted hazard ratios (95% confidence intervals) for groups 3 and 4 were 1.59 (0.76-3.30) and 1.32 (0.72-2.42), respectively, and 0.83 (0.47-1.46) for group 4 compared with group 3. The results of patients aged ≥50 years were identical to those of all patients. DISCUSSION Risk of metachronous ACRN was not different between patients aged ≥50 years who underwent polypectomy of ≥3 diminutive NAAs, ≥3 small NAAs, and AA, thus supporting current guidelines that recommend a uniform surveillance interval for these lesions.
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Jung YS, Kim NH, Park JH, Park DI, Sohn CI. Appropriate Surveillance Interval after Colonoscopic Polypectomy in Patients Younger than 50 Years. J Korean Med Sci 2019; 34:e101. [PMID: 30940997 PMCID: PMC6439201 DOI: 10.3346/jkms.2019.34.e101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 03/13/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Current postpolypectomy surveillance guidelines are based on studies in patients aged ≥50 years. Equal application of the guidelines in patients aged < 50 years may be unreasonable. We aimed to determine an appropriate surveillance interval after adenoma removal in patients aged < 50 years. METHODS We studied 10,013 patients who underwent ≥ 1 adenoma removal and follow-up colonoscopy. The cumulative risk of metachronous advanced colorectal neoplasia (ACRN) was compared among the eight groups based on age (30-39, 40-44, 45-49 and ≥ 50 years) and baseline adenoma characteristics (low- [LRA] and high-risk adenoma [HRA]). RESULTS The risk of metachronous ACRN in patients aged 30-39 and 40-44 years with HRA was comparable to that in those aged ≥ 50 years with LRA (P = 0.839 and P = 0.381, respectively). However, the risk in those aged 45-49 years with HRA was higher than in those aged ≥ 50 years with LRA (P = 0.003), and the risk was not significantly different from that in those aged ≥ 50 years with HRA (P = 0.092). Additionally, the 5-year cumulative risk in those aged 45-49 years with LRA was not significantly different from that in those aged ≥ 50 years with LRA. CONCLUSION The postpolypectomy surveillance interval can be extended up to 5 years in patients aged 30-44 years with HRA, similar to those aged ≥ 50 years with LRA. However, the interval in patients aged 45-49 years with HRA and LRA should be 3 and 5 years, respectively, similar to those aged ≥ 50 years.
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Affiliation(s)
- Yoon Suk Jung
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Nam Hee Kim
- Preventive Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung Ho Park
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong Il Park
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chong Il Sohn
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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Zhiqiang F, Jie C, Yuqiang N, Chenghua G, Hong W, Zheng S, Wanglin L, Yongjian Z, Liping D, Lizhong Z, DeJian Z. Analysis of population-based colorectal cancer screening in Guangzhou, 2011-2015. Cancer Med 2019; 8:2496-2502. [PMID: 30927329 PMCID: PMC6536937 DOI: 10.1002/cam4.1867] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 10/14/2018] [Accepted: 10/15/2018] [Indexed: 12/12/2022] Open
Abstract
Objective To analyze the detection rates of colorectal cancer (CRC) and polyps by population‐based screening in Guangzhou. Methods From January 2011 to December 2015, the residents aged 30‐79 were selected for CRC screening. The residents were conducted Questionnaires and/or FOBT to assess high‐risk groups, the free colonoscopy examination was recommended, and the results were evaluated in detail. Results There were 98 927 residents involving screening, 5306 high‐risk residents identified (males 1859 and females 3447), and 4713 subjects underwent colonoscopy (males 1690 and females 3023). CRC was seen in 55 individuals (males 28 and females 27), and the detection rates in male were higher than in female (P = 0.019). And the detection rates increasing with age, for people over 60 years old, were obviously higher than those younger (x2 = 18.64, P = 0.000924). The polyps were seen in 1458 (30.94%) cases, and 1420 subjects received pathological examination (adenomas 971 and non‐adenomatous polyps 449). Advanced adenomas were seen in 462 cases (males 240 and females 222) and 509 cases of non‐advanced adenomas (males 255 and females 254). For advanced adenomas, the detection rates in male were higher than female (14.20% vs 7.34%, P = 2.64 × 10−14). For the detection rates of adenomas or advanced adenomas by age, the people over 40 years were higher than younger (20.91% vs 3.61% P = 7.87 × 10−6; 9.94% vs 2.41%, P = 0.009). Conclusions For Guangzhou residents, the detection rates of CRC and adenoma were 1.17% and 20.60%. The detection rates of CRC increasing with age, for people over 60 years old, were obviously higher than those younger. But for people over 40 years, the detection rate of adenoma and advanced adenoma was higher than younger. So for people over 40 years, the CRC screening is recommended.
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Affiliation(s)
- Feng Zhiqiang
- Department of Gastroenterology, Guangzhou First People's Hospital, The Second Affiliated Hospital of South China University of Technology, Guangzhou, China
| | - Cao Jie
- Department of Gastrointestinal Surgery, Guangzhou First People's Hospital, The Second Affiliated Hospital of South China University of Technology, Guangzhou, China
| | - Nie Yuqiang
- Department of Gastroenterology, Guangzhou First People's Hospital, The Second Affiliated Hospital of South China University of Technology, Guangzhou, China
| | - Gong Chenghua
- Yuexiu District Center for Disease Control and Prevention, Guangzhou, China
| | - Wang Hong
- Department of Gastroenterology, Guangzhou First People's Hospital, The Second Affiliated Hospital of South China University of Technology, Guangzhou, China
| | - Sun Zheng
- Department of Gastrointestinal Surgery, Guangzhou First People's Hospital, The Second Affiliated Hospital of South China University of Technology, Guangzhou, China
| | - Li Wanglin
- Department of Gastrointestinal Surgery, Guangzhou First People's Hospital, The Second Affiliated Hospital of South China University of Technology, Guangzhou, China
| | - Zhou Yongjian
- Department of Gastroenterology, Guangzhou First People's Hospital, The Second Affiliated Hospital of South China University of Technology, Guangzhou, China
| | - Dai Liping
- Yuexiu District Center for Disease Control and Prevention, Guangzhou, China
| | - Zeng Lizhong
- Yuexiu District Center for Disease Control and Prevention, Guangzhou, China
| | - Zhao DeJian
- Yuexiu District Center for Disease Control and Prevention, Guangzhou, China
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Choi YJ, Lee DH, Han KD, Kim HS, Yoon H, Shin CM, Park YS, Kim N. Optimal Starting Age for Colorectal Cancer Screening in an Era of Increased Metabolic Unhealthiness: A Nationwide Korean Cross-Sectional Study. Gut Liver 2019; 12:655-663. [PMID: 29938455 PMCID: PMC6254626 DOI: 10.5009/gnl17514] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 02/16/2018] [Accepted: 03/29/2018] [Indexed: 12/11/2022] Open
Abstract
Background/Aims The association between metabolic syndrome and colorectal cancer (CRC) has been suggested as one of causes for the increasing incidence of CRC, particularly in younger age groups. The present study examined whether the current age threshold (50 years) for CRC screening in Korea requires modification when considering increased metabolic syndrome. Methods We analyzed data from the National Health Insurance Corporation database, which covers ~97% of the population in Korea. CRC risk was evaluated with stratification based on age and the presence/absence of relevant metabolic syndrome components (diabetes, dyslipidemia, and hypertension). Results A total of 51,612,316 subjects enrolled during 2014 to 2015 were analyzed. Among them, 19.3% had diabetes, hypertension, dyslipidemia, or some combination thereof. This population had a higher incidence of CRC than did those without these conditions, and this was more prominent in subjects <40 years of age. The optimal cutoff age for detecting CRC, based on the highest Youden index, was 45 years among individuals without diabetes, dyslipidemia, and hypertension. Individuals with at least one of these components of metabolic syndrome had the highest Youden index at 62 years old, but the value was only 0.2. Resetting the cutoff age from 50 years to 45 years achieved a 6% increase in sensitivity for CRC detection among the total population. Conclusions Starting CRC screening earlier, namely, at 45 rather than at 50 years of age, may improve secondary prevention of CRC in Korea.
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Affiliation(s)
- Yoon Jin Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Dong Ho Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Kyung-Do Han
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyun Soo Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hyuk Yoon
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Cheol Min Shin
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Young Soo Park
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Nayoung Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
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Park CH, Kim NH, Park JH, Park DI, Sohn CI, Jung YS. Impact of family history of colorectal cancer on age-specific prevalence of colorectal neoplasia. J Gastroenterol Hepatol 2019; 34:537-543. [PMID: 30462856 DOI: 10.1111/jgh.14553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 11/02/2018] [Accepted: 11/14/2018] [Indexed: 01/05/2023]
Abstract
BACKGROUND AND AIM There are no established guidelines on screening strategies for persons with a family history of colorectal cancer (CRC) in Korea. We aimed to evaluate the age-specific risk of colorectal neoplasia according to family history of CRC. METHODS Participants who underwent screening colonoscopy were included. Age-specific prevalence of non-advanced adenoma (NAA) and advanced colorectal neoplasia (ACRN) was calculated according to family history of CRC. RESULTS Among 35 997 participants, 1339 (3.7%) had a family history of CRC in first-degree relatives. A family history of CRC was an independent risk factor for NAA (adjusted odds ratio [AOR] 1.33, 95% confidence interval [CI] 1.16-1.52). In the subgroup analysis by age, family history of CRC was a risk factor for NAA in the 50-59 and ≥ 60 years groups (AOR [95% CI]: 1.42 [1.04-1.91] and 2.33 [1.34-4.09], respectively), but not in the 30-39 and 40-49 years groups. In the curve of age-specific prevalence of NAA, the gap of the prevalence between the family history and non-family history groups began to widen after the mid-50s. In cases of ACRN, a family history of CRC was not a risk factor in the entire age group (AOR 1.16, 95% CI 0.75-1.70). In the curve of age-specific prevalence of ACRN, however, the gap of the prevalence between the family history and non-family history groups began to widen after the early 60s. CONCLUSION Although a family history of CRC is a risk factor for NAA, it may affect NAA development from the mid-50s and ACRN development from the early 60s.
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Affiliation(s)
- Chan Hyuk Park
- Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
| | - Nam Hee Kim
- Preventive Health Care, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung Ho Park
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong Il Park
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chong Il Sohn
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yoon Suk Jung
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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Hasan R, Bhatt D, Khan S, Khan V, Verma AK, Bharti PS, Anees A, Dev K. Frequency of I655V SNP of HER-2/ neu in colorectal cancer: a study from India. 3 Biotech 2019; 9:11. [PMID: 30622849 DOI: 10.1007/s13205-018-1545-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Accepted: 12/16/2018] [Indexed: 02/07/2023] Open
Abstract
The present study was conducted to determine the prognostic significance of I655V SNP (rs1136201) is a genetic one in HER-2 oncoprotein in cases of colorectal cancer (CRC). We conducted a case-control study analysing 83 subjects (naïve primary CRC cases) who underwent CRC biopsy/colectomy and included 57 healthy control subjects. Analysis of HER-2 polymorphism was done by PCR-RFLP technique. The mean age was found to be 55.9 years; median age was 56 years and mode age was 54 years with a range of 43 (30-73). Males constitute 63 (75.9%) and females constitute 20 (24.1%) of patient population. According to gradewise distribution, 12 (14.45%) patients were of Grade I, 53 (63.85%) of Grade II, and 18 (21.68%) were of Grade III. We found out that out of 83 patients, 52 (62.65%) were of homozygous wild type (A/A; Ile/Ile); 27 (32.53%) were of heterozygous type (A/G; Ile/Val) and 4 (4.81%) were of homozygous mutant type (G/G; Val/Val). Allelic frequency of Ile (A) was found out to be 0.79 and that of Val (G) is 0.21 and were not significantly different from the healthy control population. Fischer's exact p value obtained was 0.86.
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Affiliation(s)
- Rameez Hasan
- 1Department of Biotechnology, Jamia Millia Islamia, Jamia Nagar, New Delhi, 110025 India
- 2Department of Surgery, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh 202001 India
| | - Deepti Bhatt
- 1Department of Biotechnology, Jamia Millia Islamia, Jamia Nagar, New Delhi, 110025 India
| | - Shahbaz Khan
- 1Department of Biotechnology, Jamia Millia Islamia, Jamia Nagar, New Delhi, 110025 India
| | - Vasiuddin Khan
- 1Department of Biotechnology, Jamia Millia Islamia, Jamia Nagar, New Delhi, 110025 India
| | - Amit Kumar Verma
- 1Department of Biotechnology, Jamia Millia Islamia, Jamia Nagar, New Delhi, 110025 India
| | - Prahalad Singh Bharti
- 3Department of Biophysics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029 India
| | - Afzal Anees
- 2Department of Surgery, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh 202001 India
| | - Kapil Dev
- 1Department of Biotechnology, Jamia Millia Islamia, Jamia Nagar, New Delhi, 110025 India
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Kim NH, Jung YS, Yang HJ, Park SK, Park JH, Park DI, Sohn CI. Prevalence of and Risk Factors for Colorectal Neoplasia in Asymptomatic Young Adults (20-39 Years Old). Clin Gastroenterol Hepatol 2019; 17:115-122. [PMID: 30025922 DOI: 10.1016/j.cgh.2018.07.011] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 06/30/2018] [Accepted: 07/04/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND & AIMS The incidence of colorectal cancer is increasing among persons 50 years old or younger. However, data on the epidemiology of young-onset colorectal neoplasia (CRN) are limited. Although some studies have investigated the epidemiology of CRN in persons younger than 50 years, most have focused on persons 40 years or older. We evaluated the prevalence of and risk factors for CRN in adults younger than 40 years. METHODS We performed a cross-sectional analysis of 72,356 asymptomatic individuals, 20-39 years old, who underwent colonoscopies as participants in the Kangbuk Samsung Health Study in South Korea, from August 2004 through December 2015. Data on medical history and health-related behavior were collected from self-administered questionnaires. Patients were divided into groups based on age (20-29 years, n = 7340 or 30-39 years, n = 65,016), and χ2 tests were used to compare categorical variables between groups. A multivariate logistic regression model was used to assess the risk factors for overall and advanced CRN. RESULTS The prevalence of overall CRN in group of 20-29 years was 5.9% and in the group of 30-39 years was 9.5% (P < .001); prevalence values for advanced CRN were 0.6% and 0.9%, respectively (P = .005). In the group of 30-39 years, age, smoking, alcohol intake, obesity, and abdominal obesity were independent risk factors for overall and advanced CRN. Additionally, male sex and metabolic syndrome were independent risk factors for overall CRN, whereas regular exercise reduced risk of overall CRN. Even in the 20-29 years group, obesity, abdominal obesity, and increased levels of triglycerides were independent risk factors for overall and advanced CRN, whereas age, increased blood pressure, and increased fasting blood glucose level were independent risk factors for overall CRN. CONCLUSION In a retrospective analysis of 72,356 asymptomatic persons under 40 years of age evaluated by colonoscopy in Korea, we found modifiable factors, such as smoking, alcohol intake, obesity, and metabolic syndrome, to be significant risk factors for CRN-even in persons of 20-39 years old. Colorectal cancer screening strategies should consider these risk factors.
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Affiliation(s)
- Nam Hee Kim
- Preventive Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yoon Suk Jung
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - Hyo-Joon Yang
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Soo-Kyung Park
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung Ho Park
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong Il Park
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chong Il Sohn
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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Hussein Kamareddine M, Ghosn Y, Karam K, Nader AA, El-Mahmoud A, Bou-Ayash N, El-Khoury M, Farhat S. Adenoma Detection before and after the age of 50: a retrospective analysis of Lebanese outpatients. BMJ Open Gastroenterol 2018; 5:e000253. [PMID: 30588324 PMCID: PMC6280908 DOI: 10.1136/bmjgast-2018-000253] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 10/26/2018] [Accepted: 10/29/2018] [Indexed: 12/18/2022] Open
Abstract
Background and aim Colorectal cancer (CRC) has an increased impact on the Lebanese population’s morbidity and mortality. This study evaluated the situation of adenoma detection in an outpatient clinic in Lebanon. Patients and methods 918 patients underwent colonoscopy over a period of 24 months by a qualified physician. Biopsy results were divided into normal versus abnormal colonic tissue, which was further subdivided into number of polyps and cancer. Results Out of 918 individuals included, 82 cases of Crohn’s colitis (8.93%) and 22 cases of ulcerative colitis (2.39%) were identified. A total of 42 cases of CRC (4.58%) and 188 cases of adenomatous polyps (20.48%) were identified. The data show that age >50 years and male gender significantly correlate with increased incidence of precancerous and cancerous polyps. Further exploring the results by age groups and gender, detection of adenomatous polyps in women aged 40–49 (8.33%) was significantly different from their female counterparts aged ≥50 years old (25.26%) (p<0.01). However, no statistical difference between detection of adenomas was found between men aged 40–49 (33.33%) and their male counterparts aged ≥50 years old (37.5%) (p=0.6). Conclusion Within the limitations of this study, the incidence of CRC and adenomatous polyps falls in the high range compared with international studies. Furthermore, symptomatic male patients aged 40–49 appear to exhibit detection rates of adenomas similar to their counterparts aged ≥50 years old. Subjects younger than 50 years underwent diagnostic rather than screening colonoscopy, which introduces some selection bias. Nevertheless, these findings can serve as a basis for further studies.
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Affiliation(s)
| | - Youssef Ghosn
- Department of Medicine and Medical Sciences, University of Balamand, El-Koura, Lebanon
| | - Karam Karam
- Department of Medicine and Medical Sciences, University of Balamand, El-Koura, Lebanon
| | - Anwar Andrew Nader
- Department of Medicine and Medical Sciences, University of Balamand, El-Koura, Lebanon
| | - Ahmad El-Mahmoud
- Department of Medicine and Medical Sciences, University of Balamand, El-Koura, Lebanon
| | - Naseem Bou-Ayash
- Department of Medicine and Medical Sciences, University of Balamand, El-Koura, Lebanon
| | - Mansour El-Khoury
- Department of General Surgery, Saint George Hospital University Medical Center, Beirut, Lebanon
| | - Said Farhat
- Department of Gastroenterology, Saint George Hospital University Medical Center, Beirut, Lebanon
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