Colorectal Neoplasm in Asymptomatic Average-risk Koreans: The KASID Prospective Multicenter Colonoscopy Survey
2
조회
0
다운로드
23
인용
0
참고문헌
키워드
초록
Background/Aims: The incidence of colorectal cancer is increasing in Korea, but the epidemiology of colorectal neoplasm is not clearly defined. We aimed to elucidate the prevalence of colorectal neoplasm in average-risk Koreans and explore the underlying risk factors. Methods: A large-scale, multicenter, prospective study was conducted. Of the 19,460 subjects who underwent colonoscopy at 11 university hospitals, we analyzed 3,951 consecutive asymptomatic adults with no risk factors for colorectal cancer. Results: The subjects were aged 52.1±11.6 years (mean±SD) and 60.1% of them were men. The prevalences of colorectal neoplasm and advanced neoplasm were 33.3% and 2.2%, respectively. The prevalence of a neoplasm increased with age (trend: p＜0.001) and was higher in males (p＜0.001). The prevalence of a proximal neoplasm was higher in subjects with a distal neoplasm than in those without a distal neoplasm (11.9% vs. 5.4%, p＜0.001). However, 150 (52.1%) of the 288 subjects with a proximal neoplasm had no distal neoplasm. Conclusions: The overall prevalence of colorectal neoplasm in asymptomatic average-risk Koreans is comparable with that in Western countries. Being male and older are associated with a higher risk of colorectal neoplasm. Over half of proximal neoplasms are not associated with any distal sentinel lesions.
Abstract
Background/Aims: The incidence of colorectal cancer is increasing in Korea, but the epidemiology of colorectal neoplasm is not clearly defined. We aimed to elucidate the prevalence of colorectal neoplasm in average-risk Koreans and explore the underlying risk factors. Methods: A large-scale, multicenter, prospective study was conducted. Of the 19,460 subjects who underwent colonoscopy at 11 university hospitals, we analyzed 3,951 consecutive asymptomatic adults with no risk factors for colorectal cancer. Results: The subjects were aged 52.1±11.6 years (mean±SD) and 60.1% of them were men. The prevalences of colorectal neoplasm and advanced neoplasm were 33.3% and 2.2%, respectively. The prevalence of a neoplasm increased with age (trend: p＜0.001) and was higher in males (p＜0.001). The prevalence of a proximal neoplasm was higher in subjects with a distal neoplasm than in those without a distal neoplasm (11.9% vs. 5.4%, p＜0.001). However, 150 (52.1%) of the 288 subjects with a proximal neoplasm had no distal neoplasm. Conclusions: The overall prevalence of colorectal neoplasm in asymptomatic average-risk Koreans is comparable with that in Western countries. Being male and older are associated with a higher risk of colorectal neoplasm. Over half of proximal neoplasms are not associated with any distal sentinel lesions.
참고문헌 (28)
- Jemal A, "Cancer statistics, 2008", CA Cancer J Clin, 58, pp.71~96 (2008)
- Yuen ST, "Colorectal carcinoma in Hong Kong: epidemiology and genetic mutations", Br J Cancer, 76, pp.1610~1616 (1997)
- Ji BT, "Colorectal cancer incidence trends by subsite in urban Shanghai, 1972-1994", Cancer Epidemiol Biomarkers Prev, 7, pp.661~666 (1998)
- Muto T, "Colorectal cancer statistics in Japan: data from JSCCR registration, 1974-1993", Int J Clin Oncol, 6, pp.171~176 (2001)
- "Annual Report on the cause of death statistics, 2005"[URL]
- Winawer SJ, "Prevention of colorectal cancer by colonoscopic polypectomy. in: The National Polyp Study Workgroup", N Engl J Med, 329, pp.1977~1981 (1993)
- Mandel JS, "The effect of fecal occult-blood screening on the incidence of colorectal cancer", N Engl J Med, 343통권 : 1, pp.1603~1607 (2000)
- Levin B, "Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology", Gastroenteroloy, 134, pp.1570~1595 (2008)
- Rhodes JM, "Colorectal cancer screening in the UK: joint position statement by the British Society of Gastroenterology, the Royal College of Physicians, and the Association of Coloproctology of Great Britain and Ireland", Gut, 46, pp.746~748 (2000)
- "WGO-OMGE position statement: colorectal cancer screening and surveillance"[URL]
- Jung SY, "Screening guidelines for the early detection of colorectal cancer. in: Panel discussion", Korean J Gastrointest Endosc, 24, pp.317~320 (2002)
- World Medical Association declaration of Helsinki, "Recommendations guiding physicians in biomedical research involving human subjects", JAMA, 277, pp.925~926 (1997)
- "National cancer screening program, 2004"[URL]
- Kim TS, "Prospective evaluation of colorectal polyps in 1,683 consecutive colonoscopies", Korean J Gastrointest Endosc, 190, pp.887~896 (1999)
- Choe JW, "Prediction of proximal colonic adenomas in patients with distal colonic polyps found on sigmoidoscopy: a controlled study", Korean J Gastroenterol, 36, pp.644~651 (2000)
- Choe JW, "Screening colonoscopy in asymptomatic average-risk Koreans: analysis in relation to age and sex", J Gastroenterol Hepatol, 22, pp.1003~1008 (2007)
- Lieberman DA, "Use of colonoscopy to screen asymptomatic adults for colorectal cancer. in: Veterans Affairs Cooperative Study Group 380", N Engl J Med, 343, pp.162~168 (2000)
- Betes M, "Use of colonoscopy as a primary screening test for colorectal cancer in average risk people", Am J Gastroenterol, 98, pp.2648~2654 (2003)
- Schoenfeld P, "Colonoscopic screening of average-risk women for colorectal neoplasia", N Engl J Med, 352, pp.2061~2068 (2005)
- Stevens T, "Colonoscopy screening in the elderly: when to stop?", Am J Gastroenterol, 98, pp.1881~1885 (2003)
- Rex DK, "Screening colonoscopy in asymptomatic average-risk African Americans", Gastrointest Endosc, 51, pp.524~527 (2000)
- Rex DK, "Colonic neoplasia in asymptomatic persons with negative fecal occult blood tests: influence of age, gender, and family history", Am J Gastroenterol, 88, pp.825~831 (1993)
- Imperiale TF, "Risk of advanced proximal neoplasms in asymptomatic adults according to the distal colorectal findings", N Engl J Med, 343, pp.169~174 (2000)
- Imperiale TF, "Using risk for advanced proximal colonic neoplasia to tailor endoscopic screening for colorectal cancer", Ann Intern Med, 139, pp.959~965 (2003)
- Levin TR, "Predicting advanced proximal colonic neoplasia with screening sigmoidoscopy", JAMA, 281, pp.1611~1617 (1999)
- Lewis JD, "Detection of proximal adenomatous polyps with screening sigmoidoscopy: a systematic review and meta-analysis of screening colonoscopy", Arch Intern Med, 163, pp.413~420 (2003)
- Pennazio M, "Small rectosigmoid polyps as markers of proximal neoplasms", Dis Colon Rectum, 36, pp.1121~1125 (1993)
- Gannon CJ, "Advanced proximal colon cancer", Surg Endosc, 16, pp.446~449 (2002)