Intest Res.  2013 Jul;11(3):169-177. 10.5217/ir.2013.11.3.169.

Predictable Factors of Early Colorectal Cancer after Colonoscopic Polypectomy

Affiliations
  • 1Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea. songhj@jejunu.ac.kr
  • 2Department of Pathology, Jeju National University School of Medicine, Jeju, Korea.
  • 3Department of Pathology, Bucheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Bucheon, Korea.

Abstract

BACKGROUND/AIMS
Colorectal cancer is the third most common cancer and the fourth leading cause of cancer death in Korea. Colonoscopic screening with removal of adenomas is an effective strategy for reducing the incidence and mortality of colorectal cancer. This study was conducted to investigate predictable factors of early colorectal cancer (ECC) in patients with advanced adenoma (AA), tumor in situ (Tis), and submucosal (SM) cancer diagnosed after colonoscopic polypectomy.
METHODS
Between August 2003 and June 2012, a total of 1,001 patients who underwent colonoscopic polypectomy in Jeju National University Hospital were enrolled in this study.
RESULTS
Patients were classified into four groups; non-AA, AA, Tis, and SM cancer. Compared to the AA group, the ECC group (n=50) had large adenoma size (12.2+/-5.9 mm vs. 15.3+/-6.5 mm, P<0.01), distal location (39.3% vs. 52.0%, P=0.05) and diabetes mellitus (13.1% vs. 25.0%, P=0.04). However, age, sex, body mass index, the mean number of polyps, and morphological features (polypoid vs. nonpolypoid lesions) were not significantly different between the AA and ECC groups. In multivariate analysis, adenoma size >15 mm (odds ratio [OR], 4.49; 95% confidence interval [CI] 2.40-8.38), distal location (OR, 2.59; 95% CI, 1.33-5.05), and diabetes mellitus (OR, 2.10; 95% CI, 1.07-4.43) were significantly associated with ECC. Of the 12 patients with SM cancer, 5 underwent additional operations and had no remnant carcinoma.
CONCLUSIONS
Predictable factors of ECC after colonoscopic polypectomy may be adenoma size >15 mm, distal location and diabetes mellitus.

Keyword

Colorectal neoplasms; Colonoscopy

MeSH Terms

Adenoma
Body Mass Index
Colonoscopy
Colorectal Neoplasms
Diabetes Mellitus
Humans
Incidence
Korea
Mass Screening
Multivariate Analysis
Polyps
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