KMID : 0191120170320081281
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Journal of Korean Medical Science 2017 Volume.32 No. 8 p.1281 ~ p.1287
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Is Colonoscopic Screening Necessary for Patients Younger than 50 Years with Gastric Adenoma or Cancer?
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Kim Nam-Hee
Park Jung-Ho Park Dong-Il Sohn Chong-Il Jung Yoon-Suk
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Abstract
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Patients, aged ¡Ã 50 years, with gastric neoplasm are reported to be at increased risk for colorectal neoplasia (CRN), while data regarding the risk of CRN in young patients, aged < 50 years with gastric neoplasm are limited. We aimed to investigate the risk of CRN according to the presence of gastric neoplasm in patients, aged < 50 years, and conducted a cross-sectional study on 131,888 asymptomatic examinees who underwent both esophagogastroduodenoscopy (EGD) and colonoscopy as part of a health screening program between 2010 and 2014. The prevalence of overall CRN (8.6% vs. 13.2%, P = 0.251) and advanced colorectal neoplasia (ACRN) (0.0% vs. 1.3%, P = 0.345) did not significantly differ according to the presence of gastric neoplasm in subjects, aged < 50 years. However, among subjects aged ¡Ã 50 years, patients with gastric neoplasm had a significantly higher proportion of overall CRN (48.2% vs. 31.7%, P < 0.001) and ACRN (12.5% vs. 4.5%, P < 0.001) compared with those without gastric neoplasm. Particularly, gastric neoplasm was an independent risk factor for ACRN after controlling for confounding factors among subjects, aged ¡Ã 50 years. In conclusion, gastric neoplasm was a risk factor for CRN in patients, aged ¡Ã 50 years, but not in patients, aged < 50 years. Young patients, aged < 50 years with gastric neoplasm do not need to undergo colonoscopy, whereas patients, aged ¡Ã 50 years with gastric neoplasm, should be considered a higher priority for colonoscopy.
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KEYWORD
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Colorectal Neoplasm, Gastric Neoplasm, Colonoscopy, Young
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