Is Colonoscopic Screening Necessary for Patients Younger than 50 Years with Gastric Adenoma or Cancer?
Journal of Korean Medical Science 2017³â 32±Ç 8È£ p.1281 ~ p.1287
±è³²Èñ(Kim Nam-Hee) - Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Preventive Healthcare Center
¹ÚÁ¤È£(Park Jung-Ho) - Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Internal Medicine
¹Úµ¿ÀÏ(Park Dong-Il) - Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Internal Medicine
¼ÕÁ¤ÀÏ(Sohn Chong-Il) - Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Internal Medicine
Á¤À±¼÷(Jung Yoon-Suk) - Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Internal Medicine
Abstract
Patients, aged ¡Ã 50 years, with gastric neoplasm are reported to be at increased risk for colorectal neoplasia (CRN), while data regarding the risk of CRN in young patients, aged < 50 years with gastric neoplasm are limited. We aimed to investigate the risk of CRN according to the presence of gastric neoplasm in patients, aged < 50 years, and conducted a cross-sectional study on 131,888 asymptomatic examinees who underwent both esophagogastroduodenoscopy (EGD) and colonoscopy as part of a health screening program between 2010 and 2014. The prevalence of overall CRN (8.6% vs. 13.2%, P = 0.251) and advanced colorectal neoplasia (ACRN) (0.0% vs. 1.3%, P = 0.345) did not significantly differ according to the presence of gastric neoplasm in subjects, aged < 50 years. However, among subjects aged ¡Ã 50 years, patients with gastric neoplasm had a significantly higher proportion of overall CRN (48.2% vs. 31.7%, P < 0.001) and ACRN (12.5% vs. 4.5%, P < 0.001) compared with those without gastric neoplasm. Particularly, gastric neoplasm was an independent risk factor for ACRN after controlling for confounding factors among subjects, aged ¡Ã 50 years. In conclusion, gastric neoplasm was a risk factor for CRN in patients, aged ¡Ã 50 years, but not in patients, aged < 50 years. Young patients, aged < 50 years with gastric neoplasm do not need to undergo colonoscopy, whereas patients, aged ¡Ã 50 years with gastric neoplasm, should be considered a higher priority for colonoscopy.
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Colorectal Neoplasm, Gastric Neoplasm, Colonoscopy, Young
KMID :
0191120170320081281
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À¯È¿¼º°á°ú(Recomendation)
Gastric neoplasm was a risk factor for CRN in patients, aged ¡Ã 50 years, but not in patients, aged < 50 years. Young patients, aged < 50 years with gastric neoplasm do not need to undergo colonoscopy, whereas patients, aged ¡Ã 50 years with gastric neoplasm, should be considered a higher priority for colonoscopy.