Published online Apr 7, 2016. doi: 10.3748/wjg.v22.i13.3611
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.
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.