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Screening for colorectal lesions with high-resolution video colonoscopes in a German male average-risk population at 40 to 59 years of age.
Z Gastroenterol. 2007 Sep; 45(9):952-7.ZG

Abstract

BACKGROUND

Prevalence data for colorectal neoplastic lesions obtained from screening colonoscopies have recently been reported for a U. S. American and a Polish average-risk population. However, prevalence data for a German average-risk population have not been published.

METHODS

From 1998 until 2003 a screening colonoscopy was offered to all male participants of a health assessment program. In a total of 618 volunteers with an average risk for colorectal cancer, polypoid lesions were identified and removed using high-resolution video colonoscopes. The histological features of the lesions were categorised according to those of the most advanced one. An advanced lesion was defined as an adenoma of at least 1 cm in diameter, a polyp with villous histological features or high-grade intraepithelial neoplasms or a cancer. Data were analysed in two groups: age 40 - 49 years (group A) and age 50 - 59 years (group B).

RESULTS

In group A (age 40 - 49 years, n = 285), 133 subjects (47 %) had polypoid lesions. Histological findings revealed that 57 subjects (20 %) had non-neoplastic and 76 subjects (27 %) had neoplastic lesions. In nine cases (3.2 %) polyps were classified as advanced lesions with a maximal diameter of 35 mm. In group B (age 50 - 59, n = 333), 183 subjects (55 %) had polypoid lesions. Histological findings revealed that 64 subjects (19 %) had non-neoplastic and 119 subjects (36 %) had neoplastic lesions. Among those, 34 (10.2 %) had advanced lesions with a maximal diameter of 55 mm. In neither group was an invasive cancer detected. The difference in the prevalence of neoplastic lesions between the two age groups was statistically significant (chi (2) = 5.85). An exceptionally high rate of 27 % neoplastic lesions was detected in subjects at 40 to 49 years of age. The rate of detected lesions in the group of older subjects was 36 %.

CONCLUSION

By using high-resolution endoscopes we found an unexpectedly large number of neoplastic lesions in the colon even in a relatively young average-risk population. The question whether screening colonoscopy should therefore not only aim at detecting early colorectal cancer but also at identifying and removing precursor adenomas at younger ages clearly deserves further attention.

Authors+Show Affiliations

Department of Internal Medicine, Federal Armed Forces Hospital Ulm, Ulm, Germany. roland.eisele@extern.uni-ulm.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17874357

Citation

Eisele, R, et al. "Screening for Colorectal Lesions With High-resolution Video Colonoscopes in a German Male Average-risk Population at 40 to 59 Years of Age." Zeitschrift Fur Gastroenterologie, vol. 45, no. 9, 2007, pp. 952-7.
Eisele R, Vogelsang E, Kraft K, et al. Screening for colorectal lesions with high-resolution video colonoscopes in a German male average-risk population at 40 to 59 years of age. Z Gastroenterol. 2007;45(9):952-7.
Eisele, R., Vogelsang, E., Kraft, K., Baumgarten, U., & Schick, R. R. (2007). Screening for colorectal lesions with high-resolution video colonoscopes in a German male average-risk population at 40 to 59 years of age. Zeitschrift Fur Gastroenterologie, 45(9), 952-7.
Eisele R, et al. Screening for Colorectal Lesions With High-resolution Video Colonoscopes in a German Male Average-risk Population at 40 to 59 Years of Age. Z Gastroenterol. 2007;45(9):952-7. PubMed PMID: 17874357.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Screening for colorectal lesions with high-resolution video colonoscopes in a German male average-risk population at 40 to 59 years of age. AU - Eisele,R, AU - Vogelsang,E, AU - Kraft,K, AU - Baumgarten,U, AU - Schick,R R, PY - 2007/9/18/pubmed PY - 2007/12/14/medline PY - 2007/9/18/entrez SP - 952 EP - 7 JF - Zeitschrift fur Gastroenterologie JO - Z Gastroenterol VL - 45 IS - 9 N2 - BACKGROUND: Prevalence data for colorectal neoplastic lesions obtained from screening colonoscopies have recently been reported for a U. S. American and a Polish average-risk population. However, prevalence data for a German average-risk population have not been published. METHODS: From 1998 until 2003 a screening colonoscopy was offered to all male participants of a health assessment program. In a total of 618 volunteers with an average risk for colorectal cancer, polypoid lesions were identified and removed using high-resolution video colonoscopes. The histological features of the lesions were categorised according to those of the most advanced one. An advanced lesion was defined as an adenoma of at least 1 cm in diameter, a polyp with villous histological features or high-grade intraepithelial neoplasms or a cancer. Data were analysed in two groups: age 40 - 49 years (group A) and age 50 - 59 years (group B). RESULTS: In group A (age 40 - 49 years, n = 285), 133 subjects (47 %) had polypoid lesions. Histological findings revealed that 57 subjects (20 %) had non-neoplastic and 76 subjects (27 %) had neoplastic lesions. In nine cases (3.2 %) polyps were classified as advanced lesions with a maximal diameter of 35 mm. In group B (age 50 - 59, n = 333), 183 subjects (55 %) had polypoid lesions. Histological findings revealed that 64 subjects (19 %) had non-neoplastic and 119 subjects (36 %) had neoplastic lesions. Among those, 34 (10.2 %) had advanced lesions with a maximal diameter of 55 mm. In neither group was an invasive cancer detected. The difference in the prevalence of neoplastic lesions between the two age groups was statistically significant (chi (2) = 5.85). An exceptionally high rate of 27 % neoplastic lesions was detected in subjects at 40 to 49 years of age. The rate of detected lesions in the group of older subjects was 36 %. CONCLUSION: By using high-resolution endoscopes we found an unexpectedly large number of neoplastic lesions in the colon even in a relatively young average-risk population. The question whether screening colonoscopy should therefore not only aim at detecting early colorectal cancer but also at identifying and removing precursor adenomas at younger ages clearly deserves further attention. SN - 0044-2771 UR - https://www.unboundmedicine.com/medline/citation/17874357/Screening_for_colorectal_lesions_with_high_resolution_video_colonoscopes_in_a_German_male_average_risk_population_at_40_to_59_years_of_age_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-2007-963477 DB - PRIME DP - Unbound Medicine ER -