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Advanced Colonic Neoplasia at Follow-up Colonoscopy According to Risk Components and Adenoma Location at Index Colonoscopy: A Retrospective Study of 1,974 Asymptomatic Koreans

 Su Jung Baik  ;  Hyojin Park  ;  Jae Jun Park  ;  Hyun Ju Lee  ;  So Young Jo  ;  Yoo Mi Park  ;  Hye Sun Lee 
 GUT AND LIVER, Vol.11(5) : 667-673, 2017 
Journal Title
Issue Date
Adenoma/epidemiology ; Adenoma/etiology ; Adenoma/pathology* ; Asymptomatic Diseases ; Colon/pathology ; Colon/surgery ; Colonic Neoplasms/epidemiology ; Colonic Neoplasms/etiology ; Colonic Neoplasms/pathology* ; Colonic Polyps/complications* ; Colonic Polyps/surgery ; Colonoscopy/methods* ; Early Detection of Cancer/methods ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Mass Screening/methods ; Middle Aged ; Postoperative Complications ; Proportional Hazards Models ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Assessment ; Risk Factors
Colonic neoplasms ; Colonoscopy ; Early detection of cancer
Background/Aims: We aimed to estimate the cumulative incidence of advanced colonic neoplasia and analyze the risk factors for advanced colonic neoplasia according to risk components and adenoma location at index colonoscopy. Methods: We reviewed 1,974 subjects who underwent a follow-up colonoscopy after a complete screening colonoscopy and the removal of all polyps. We estimated the cumulative incidence of a subsequent advanced neoplasia according to risk groups (normal, low-risk, and high-risk). Risk factors were analyzed by risk components (≥3 adenomas, adenoma ≥1 cm, and villous-type adenoma) and adenoma location. Results: Overall, 111 advanced neoplasias (5.6%) were newly diagnosed at the follow-up colonoscopy. The 3-year cumulative incidences of advanced neoplasia were 0.8%, 3.1%, and 10.2% in the normal, low-risk, and high-risk groups, respectively (p<0.0001), and the 5-year cumulative incidences were 2.2%, 8.6%, and 20.2%, respectively (p<0.0001). Age ≥60 years (hazard ratio [HR], 1.78; 95% confidence interval [CI], 1.21 to 2.63), right-sided colonic adenoma (HR, 1.74; 95% CI, 1.13 to 2.66), ≥3 adenomas (HR, 2.00; 95% CI, 1.22 to 3.28), and adenomas ≥1 cm in size (HR, 2.03; 95% CI, 1.20 to 3.44) in the index colonoscopy were independent risk factors for subsequent development of advanced neoplasia. Conclusions: Right-sided colonic adenoma, ≥3 adenomas, adenomas ≥1 cm, and age ≥60 years at the index colonoscopy were significant risk factors for advanced neoplasia following a complete screening colonoscopy and removal of all polyps.
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1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Yoo Mi(박유미) ORCID logo https://orcid.org/0000-0002-3642-7300
Park, Jae Jun(박재준)
Park, Hyo Jin(박효진) ORCID logo https://orcid.org/0000-0003-4814-8330
Baik, Su Jung(백수정) ORCID logo https://orcid.org/0000-0002-3790-7701
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
Jo, So Young(조소영) ORCID logo https://orcid.org/0000-0002-4995-6842
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