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Risk of developing advanced colorectal neoplasia after removing high‐risk adenoma detected at index colonoscopy in young patients: A KASID study
Author(s) -
Park SooKyung,
Kim Nam Hee,
Jung Yoon Suk,
Kim Won Hee,
Eun Chang Soo,
Ko Bong Min,
Seo Geom Seog,
Cha Jae Myung,
Park Jae Jun,
Kim Kyeong Ok,
Moon Chang Mo,
Jung Yoonho,
Kim Eun Soo,
Jeon Seong Ran,
Lee Chang Kyun,
Park Dong Il
Publication year - 2016
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.13167
Subject(s) - medicine , colonoscopy , cumulative incidence , adenoma , hazard ratio , incidence (geometry) , colorectal adenoma , gastroenterology , retrospective cohort study , confidence interval , dysplasia , risk factor , colorectal cancer , cancer , physics , transplantation , optics
Background and Aim: Advanced adenoma (> 10 mm in diameter, villous structure, or high‐grade dysplasia) in young patients may have different characteristics and prognosis compared with those in older patients. We aimed to compare the incidence of colorectal neoplasms in young patients with older patients after removing high‐risk adenoma (advance adenoma or ≥ 3 adenomas). Methods: A retrospective, multicenter study was conducted at 13 university hospitals in Korea. The 1479 patients who removed high‐risk adenoma at index colonoscopy and followed by surveillance colonoscopy ≥ 2.5 years after were included. The cumulative incidence of overall and advanced colorectal neoplasms was compared according to the age groups (group 1: < 50 years, group 2: 50–70 years, and group 3: ≥ 70 years). Results: The prevalence of advance adenoma detected at index colonoscopy was significantly higher in group 1 than in groups 2 and 3 (85.4%, 78.1%, and 77.2%, respectively; P = 0.035). The 5 years cumulative incidence of overall and advanced colorectal neoplasms were 61.9%, 67.9%, and 74.7% ( P < 0.001), and 11.7%, 17.9%, and 27.1% ( P = 0.001) in groups 1, 2, and 3, respectively. In multivariate analysis, age > 70 years was a significant risk factor for developing overall (hazard ratio [HR] 1.41, 95% confidence interval [CI] 1.12–1.82, P = 0.004) and advanced colorectal neoplasms (HR = 2.56, 95% CI 1.43–4.59, P = 0.002). Conclusion: The cumulative incidence of overall and advanced colorectal neoplasms was significantly higher in older patients than in young patient groups. Age was a significant risk factor for developing colorectal neoplasms after removing high‐risk adenoma.