Endoscopy 2006; 38(5): 449-455
DOI: 10.1055/s-2006-925227
Original Article
© Georg Thieme Verlag KG Stuttgart · New York

Diagnostic Yield of Advanced Colorectal Neoplasia at Colonoscopy, According to Indications: An Investigation from the Korean Association for the Study of Intestinal Diseases (KASID)

D.  I.  Park1 , Y.  H.  Kim2 , H.  S.  Kim3 , W.  H.  Kim3 , T.  I.  Kim3 , H.  J.  Kim4 , S.  K.  Yang5 , J.  S.  Byeon5 , M.  S.  Lee6 , I.  K.  Jung6 , M.  K.  Chung7 , S.  A.  Jung8 , Y.  T.  Jeen9 , J.  H.  Choi9 , H.  Choi10 , D.  S.  Han11 , J.  S.  Song12
  • 1Kangbuk Samsung Hospital, Sungkyun University School of Medicine, Seoul, South Korea
  • 2Samsung Medical Center, Sungkyun University School of Medicine, Seoul, South Korea
  • 3Yonsei University, Wonju & Seoul, South Korea
  • 4Kyunghee University, Seoul, South Korea
  • 5Ulsan University, Seoul, South Korea
  • 6Soonchunhyang University, Bucheon, South Korea
  • 7Youngnam University, Taegu, South Korea
  • 8Ewha Women’s University, Seoul, South Korea
  • 9Korea University, Ansan & Seoul, South Korea
  • 10Catholic University, Bucheon, South Korea
  • 11Hanyang University College of Medicine, Kuri, South Korea
  • 12Department of Preventive Medicine, Kwandong University College of Medicine, Kangneung, South Korea
Further Information

Publication History

Submitted 7 April 2005

Accepted after revision 4 August 2005

Publication Date:
09 May 2006 (online)

Background and Study Aims: The factors that more accurately predict the detection of colorectal cancers and adenomas at colonoscopy are different. We conducted a prospective multicenter study to evaluate which indications were most closely associated with advanced colorectal neoplasm (CRN), including colorectal cancer, in a group of patients undergoing colonoscopy.
Patients and Methods: The 17 468 patients were enrolled in this study between July 2003 and March 2004, from 11 tertiary medical centers in Korea. They were recruited according to 11 itemized colonoscopic indications. The term “advanced adenoma” refers here to tubular adenomas of diameter of 11 mm or more, or to tubulovillous, villous, or severely dysplastic adenomas, irrespective of their size. Cancer was defined as the invasion of malignant cells beyond the muscularis mucosa. Advanced CRN was defined as advanced adenoma or invasive cancer.
Results: Advanced CRN was found in 1227/17 307 patients (1176 advanced adenomas plus 51 carcinomas, 7.1 %). According to univariate and multivariate analysis, the factors associated with advanced CRN included age >60 years (odds ratio (OR) 2.1, 95 % confidence interval (CI) 1.8 - 2.4, P < 0.0001), male gender (OR 2.1, 95 %CI 1.7 - 2.7, P < 0.0001), referral for colonoscopy from primary care physician (OR 3.1, 95 %CI 2.5 - 3.7, P < 0.0001), and several other indications (OR 1.8, 95 %CI 1.5 - 2.3, P < 0.001). The yield of colonoscopy for advanced CRN was lower (2.2 %) than expected in patients with iron-deficiency anemia (OR 0.5, 95 %CI 0.2 - 0.9, P = 0.03).
Conclusions: Age, gender, and referral for colonoscopy from primary care physician constituted important independent predictors of advanced CRN in patients undergoing colonoscopy.

References

Y.-H. Kim

Samsung Medical Center

50 Irwon-dong, Gangnam-ku · 135-230 Seoul · Korea ·

Fax: +82-2-34103849

Email: [email protected]