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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.
Gut Liver. 2017 Sep 15; 11(5):667-673.GL

Abstract

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.

Authors+Show Affiliations

Healthcare Research Team of Health Promotion Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.Division of Gastroenterology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.Division of Gastroenterology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.Healthcare Research Team of Health Promotion Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.Healthcare Research Team of Health Promotion Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.Healthcare Research Team of Health Promotion Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.Biostatistics Collaboration Unit, Medical Research Center, Yonsei University College of Medicine, Seoul, Korea.

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

28750483

Citation

Baik, Su Jung, et al. "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." Gut and Liver, vol. 11, no. 5, 2017, pp. 667-673.
Baik SJ, Park H, Park JJ, et al. 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. Gut Liver. 2017;11(5):667-673.
Baik, S. J., Park, H., Park, J. J., Lee, H. J., Jo, S. Y., Park, Y. M., & Lee, H. S. (2017). 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. Gut and Liver, 11(5), 667-673. https://doi.org/10.5009/gnl16402
Baik SJ, et al. 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. Gut Liver. 2017 Sep 15;11(5):667-673. PubMed PMID: 28750483.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 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. AU - Baik,Su Jung, AU - Park,Hyojin, AU - Park,Jae Jun, AU - Lee,Hyun Ju, AU - Jo,So Young, AU - Park,Yoo Mi, AU - Lee,Hye Sun, PY - 2016/08/12/received PY - 2016/12/12/revised PY - 2017/02/08/accepted PY - 2017/7/29/pubmed PY - 2018/5/17/medline PY - 2017/7/28/entrez KW - Colonic neoplasms KW - Colonoscopy KW - Early detection of cancer SP - 667 EP - 673 JF - Gut and liver JO - Gut Liver VL - 11 IS - 5 N2 - 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. SN - 2005-1212 UR - https://www.unboundmedicine.com/medline/citation/28750483/Advanced_Colonic_Neoplasia_at_Follow_up_Colonoscopy_According_to_Risk_Components_and_Adenoma_Location_at_Index_Colonoscopy:_A_Retrospective_Study_of_1974_Asymptomatic_Koreans_ L2 - http://www.gutnliver.org/journal/view.html?doi=10.5009/gnl16402 DB - PRIME DP - Unbound Medicine ER -