Soo-Kyung Park1, Nam Hee Kim1, Yoon Suk Jung1, Won Hee Kim2, Chang Soo Eun3, Bong Min Ko4, Geom Seog Seo5, Jae Myung Cha6, Jae Jun Park7, Kyeong Ok Kim8, Chang Mo Moon9, Yoonho Jung10, Eun Soo Kim11, Seong Ran Jeon12, Chang Kyun Lee13, Dong Il Park1. 1. Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine. 2. Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam. 3. Department of Internal Medicine, Hanyang University Guri Hospital, Guri. 4. Digestive Disease Center and Research Institute, Department of Internal Medicine, Soonchunhyang University School of Medicine, Bucheon. 5. Department of Internal Medicine, Digestive Disease Research Institute, Wonkwang University College of Medicine, Iksan. 6. Department of Internal Medicine, Kyung Hee University Hospital at Gang Dong. 7. Division of Gastroenterology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine. 8. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine. 9. Department of Internal Medicine, School of Medicine, Ewha Womans University. 10. Department of Medicine, Division of Gastroenterology, Soonchunhyang University College of Medicine, Cheonan, Korea. 11. Division of Gastroenterology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu. 12. Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University College of Medicine, Seoul. 13. Department of Internal Medicine, Kyung Hee University School of Medicine.
Abstract
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.
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.
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