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Risks of colorectal advanced neoplasia in young adults versus those of screening colonoscopy in patients aged 50 to 54 years

Authors
 Kyeong Ok Kim  ;  Hyo-Joon Yang  ;  Jae Myung Cha  ;  Jeong Eun Shin  ;  Hyun Gun Kim  ;  Young-Seok Cho  ;  Sun-Jin Boo  ;  Jun Lee  ;  Yunho Jung  ;  Hyun Jung Lee  ;  Kyu Chan Huh  ;  Young-Eun Joo  ;  Jongha Park  ;  Chang Mo Moon 
Citation
 JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Vol.32(11) : 1825-1831, 2017-11 
Journal Title
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
ISSN
 0815-9319 
Issue Date
2017-11
MeSH
Age Factors ; Cohort Studies ; Colonoscopy* ; Colorectal Neoplasms / diagnosis* ; Colorectal Neoplasms / pathology ; Colorectal Neoplasms / prevention & control ; Female ; Humans ; Male ; Mass Screening* ; Middle Aged ; Neoplasm Staging ; Retrospective Studies ; Risk
Keywords
colonoscopy ; colorectal neoplasm ; screening ; young adults
Abstract
Background and aim: The role of screening or diagnostic colonoscopy to detect advanced neoplasia in young cohorts of age < 50 is unclear. This study compared the risk of colorectal neoplasia in a young age cohort against that in 50-54s screening cohort.

Methods: A multi-center retrospective study was conducted at 14 university hospitals to compare the detection rates of neoplasia and advanced neoplasia in screening or diagnostic colonoscopy in the young cohort of < 50s against those in screening colonoscopy in the 50-54s cohort.

Results: Among 10 477 eligible subjects, 9765 subjects were enrolled after excluding 712 subjects. Advanced neoplasia detection rates in the young screening cohort was significantly lower than that in the 50-54s screening cohort (5.9% vs 9.3%, P < 0.001). Compared with 50-54s screening cohort, the risk of advanced neoplasia was significantly reduced by 23%, 53%, and 54% in the 45-49s, 40-44s, and 20-39s screening cohorts, respectively. The detection rates of advanced neoplasia in the young diagnostic cohort was 5.0%, which was much lower than 11.8% in 50-54s screening cohort (P < 0.001). Compared with the 50-54s screening cohort, the risk of advanced neoplasia was significantly reduced by 50%, 66%, and 71% in the 45-49s, 40-44s, and 20-39s diagnostic cohorts, respectively.

Conclusions: Colonoscopy to detect advanced neoplasia in young adults aged < 50 years should be reconsidered as their risk of advanced neoplasia on screening or diagnostic colonoscopy was much lower than those of 50-54s screening cohort; however, colonoscopy screening may be justified for high-risk 45-49s cohorts.
Full Text
https://onlinelibrary.wiley.com/doi/10.1111/jgh.13798
DOI
10.1111/jgh.13798
Appears in Collections:
1. College of Medicine (의과대학) > Others (기타) > 1. Journal Papers
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/195767
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