Retrospective Cohort Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 7, 2016; 22(13): 3611-3620
Published online Apr 7, 2016. doi: 10.3748/wjg.v22.i13.3611
Different risk factors for advanced colorectal neoplasm in young adults
Ji Yeon Kim, Yoon Suk Jung, Jung Ho Park, Hong Joo Kim, Yong Kyun Cho, Chong Il Sohn, Woo Kyu Jeon, Byung Ik Kim, Kyu Yong Choi, Dong Il Park
Ji Yeon Kim, Comprehensive Health Care Center, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul 10812, South Korea
Yoon Suk Jung, Jung Ho Park, Hong Joo Kim, Yong Kyun Cho, Chong Il Sohn, Woo Kyu Jeon, Byung Ik Kim, Kyu Yong Choi, Dong Il Park, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, South Korea
Author contributions: Kim JY analyzed the data and wrote the manuscript as a first author; Park DI organized and supervised the study as a corresponding author; Jung YS, Park JH and Kim HJ contributed to collect and arrange the data; Cho YK and Sohn CI attended to analyze the data; Jeon WK supported the statistical analysis; Kim BI attended to revise the manuscript and Choi KY created the study concept and design.
Institutional review board statement: The study was reviewed and approved by the Kangbuk Samsung Hospital Institutional Review Board.
Informed consent statement: This study can prejudice the study participants no more than minimal risk. Data which were used in this study were already acquired for report of the result to subjects who had examination and administration of the result. The present study could contribute to preventing the disease through interpretation and application of the results of health care examination. There will be no risk to participants because this study will be analyzed retrospectively using only obtained data without additional administration of medicine, treatment or examination. Kangbuk Samsung Hospital institutional review board exempted the written informed consent of the present study.
Conflict-of-interest statement: None of the authors have any conflicts of interest or financial arrangements that could potentially influence the described research.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Dong Il Park, MD, PhD, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, South Korea.
Telephone: +82-2-20012059 Fax: +82-2-20012049
Received: December 16, 2015
Peer-review started: December 17, 2015
First decision: January 28, 2016
Revised: February 10, 2016
Accepted: March 2, 2016
Article in press: March 2, 2016
Published online: April 7, 2016

AIM: To compare the risk of developing advanced colorectal neoplasm (ACRN) according to age in Koreans.

METHODS: A total of 70428 Koreans from an occupational cohort who underwent a colonoscopy between 2003 and 2012 at Kangbuk Samsung Hospital were retrospectively selected. We evaluated and compared odds ratios (OR) for ACRN between the young-adults (YA < 50 years) and in the older-adults (OA ≥ 50 years). ACRN was defined as an adenoma ≥ 10 mm in diameter, adenoma with any component of villous histology, high-grade dysplasia, or invasive cancer.

RESULTS: In the YA group, age (OR = 1.08, 95%CI: 1.06-1.09), male sex (OR = 1.26, 95%CI: 1.02-1.55), current smoking (OR = 1.37, 95%CI: 1.15-1.63), family history of colorectal cancer (OR = 1.46, 95%CI: 1.01-2.10), diabetes mellitus related factors (OR = 1.27, 95%CI: 1.06-1.54), obesity (OR = 1.23, 95%CI: 1.03-1.47), CEA (OR = 1.04, 95%CI: 1.01-1.09) and low-density lipoprotein-cholesterol (OR = 1.01, 95%CI: 1.01-1.02) were related with an increased risk of ACRN. However, age (OR = 1.08, 95%CI: 1.06-1.09), male sex (OR = 2.12, 95%CI: 1.68-2.68), current smoking (OR = 1.38, 95%CI: 1.12-1.71), obesity (OR = 1.34, 95%CI: 1.09-1.65) and CEA (OR = 1.05, 95%CI: 1.01-1.09) also increased the risk of ACRN in the OA group.

CONCLUSION: The risks of ACRN differed based on age group. Different colonoscopic screening strategies are appropriate for particular subjects with risk factors for ACRN, even in subjects younger than 50 years.

Keywords: Young-adult, Advanced colorectal neoplasm, Risk factors, Age, Metabolic abnormality

Core tip: The development of colorectal cancer can be prevented through screening colonoscopy with detection and removal of advanced colorectal adenomas. Age is an important risk factor for development of advanced colorectal neoplasm (ACRN). Risk factors for the development of ACRN differ between young adults (YA, < 50 years) and older adults (OA, ≥ 50 years). Metabolic abnormalities including diabetes mellitus related factors and serum level of low-density lipoprotein-cholesterol were more related with increased risk of ACRN in the YA group. Different colonoscopic screening strategies would be appropriate to the particular subjects with risk factors for ACRN, even those younger than 50 years.