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The effect of small or diminutive adenomas at baseline colonoscopy on the risk of developing metachronous advanced colorectal neoplasia: KASID multicenter study

Authors
 Chang Mo Moon  ;  Sung-Ae Jung  ;  Chang Soo Eun  ;  Jae Jun Park  ;  Geom Seog Seo  ;  Jae Myung Cha  ;  Sung Chul Park  ;  Jaeyoung Chun  ;  Hyun Jung Lee  ;  Yunho Jung  ;  Sun-Jin Boo  ;  Jin Oh Kim  ;  Young-Eun Joo  ;  Dong Il Park 
Citation
 DIGESTIVE AND LIVER DISEASE, Vol.50(8) : 847-852, 2018 
Journal Title
 DIGESTIVE AND LIVER DISEASE 
ISSN
 1590-8658 
Issue Date
2018
MeSH
Adenoma/classification ; Adenoma/diagnosis* ; Adenoma/pathology ; Adult ; Aged ; Aged, 80 and over ; Colonoscopy* ; Colorectal Neoplasms/classification ; Colorectal Neoplasms/diagnosis* ; Colorectal Neoplasms/pathology ; Female ; Humans ; Longitudinal Studies ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasms, Second Primary/epidemiology* ; Neoplasms, Second Primary/pathology ; Practice Guidelines as Topic ; Proportional Hazards Models ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Time Factors ; Young Adult
Keywords
Diminutive adenoma ; Metachronous colorectal neoplasia ; Small adenoma ; Surveillance
Abstract
BACKGROUND: The clinical significance of diminutive or small adenomas remains ill defined. AIMS: We evaluated the clinical impact of diminutive or small adenomas at baseline on the risk of developing metachronous advanced colorectal neoplasia (CRN). METHODS: This multicenter, retrospective cohort study included 2252 patients with 1 or more colorectal adenomas at baseline and subsequent follow-up colonoscopy. Baseline colonoscopy findings were classified into 5 groups: 1 or 2 tubular adenomas (TAs) (<10 mm); 3-10 diminutive TAs (≤5 mm); 3-10 TAs, including 1 or 2 small adenomas (6-10 mm); 3-10 TAs, including 3 or more small adenomas; and advanced adenoma. RESULTS: In multivariate analysis, after adjusting for possible confounding variables (age at baseline, sex, body mass index, smoking habits, family history of colorectal cancer, regular use of aspirin or NSAIDs, and adenoma location), 3-10 TAs including 3 or more small adenomas (hazard ratio [HR] = 2.36, p = 0.034) and advanced adenoma (HR = 2.14, p < 0.001) were independent predictors for the risk of developing metachronous advanced CRN. However, 3-10 diminutive TAs or 3-10 TAs, including 1 or 2 small adenomas, were not associated with this outcome. CONCLUSIONS: Multiplicity of diminutive TAs, without advanced lesions, showed no clinical significance for risk of developing metachronous advanced CRN.
Full Text
https://www.sciencedirect.com/science/article/pii/S1590865818306960
DOI
10.1016/j.dld.2018.04.001
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Jae Jun(박재준)
Lee, Hyun Jung(이현정)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/174466
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