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Advanced Adenoma (advanced + adenoma)
Selected AbstractsPrevalence and risk of colorectal adenoma in asymptomatic Koreans aged 40,49 years undergoing screening colonoscopyJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 3 2010Su Jin Chung Abstract Background and Aim:, Colorectal cancer screening is recommended for average-risk persons beginning at age 50. However, information about the incidence and risk factors of precursor adenoma in preceding decades is limited. The aim of this study was to determine the prevalence and risk factors of colorectal adenoma in persons aged 40,49 years and to compare the data with those aged 30,39 years and 50,59 years. Methods:, A cross-sectional study of 5254 asymptomatic subjects who underwent screening colonoscopy was conducted. Data were stratified by age into three groups: 608 aged 30,39 years, 1930 aged 40,49 years, and 2716 aged 50,59 years. Results:, Prevalence of overall adenomas was 10.4% in the 30,39 years age group, 22.2% in the 40,49 years age group, and 32.8% in the 50,59 years age group. Advanced adenoma was found in 0.7% of the 30,39 years age group, 2.7% of the 40,49 years age group, and 4.1% of the 50,59 years age group. In the 40,49 years age group, male sex and current smoking habits showed associations with low-risk adenoma after multiple adjustments. Moreover, male sex (odds ratio [OR] = 1.55, 95% confidence interval [CI]: 1.02,3.23), current smoking (OR = 1.58, 95%CI: 1.06,3.50), and family history of colorectal cancer (OR = 2.54, 95%CI: 1.16,5.56) were independent predictors of advanced adenoma in this age group. Conclusions:, Prevalence of adenoma in subjects aged 40,49 years was higher than in previous studies. Male sex and current smoking habits along with a family history of colorectal cancer were associated with advanced adenoma in this age group. [source] Systematic review: distribution of advanced neoplasia according to polyp size at screening colonoscopyALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 2 2010C. HASSAN Summary Background, The impact of not referring sub-centimetre polyps identified at CT colonography upon the efficacy of colorectal cancer screening remains uncertain. Aim, To determine the distribution of advanced neoplasia according to polyp size in a screening setting. Methods, Published studies reporting the distribution of advanced adenomas in asymptomatic screening cohorts according to polyp size were identified by MEDLINE and EMBASE searches. Predefined outputs were the screening rates of advanced adenomas represented by diminutive (,5 mm), small (6,9 mm), sub-centimetre (<10 mm) and large (,10 mm) polyp sizes. Results, Data from four studies with 20 562 screening subjects met the primary inclusion criteria. Advanced adenomas were detected in 1155 (5.6%) subjects (95% CI = 5.3,5.9), corresponding to diminutive, small and large polyps in 4.6% (95% CI = 3.4,5.8), 7.9% (95% CI = 6.3,9.4) and 87.5% (95% CI = 86,89.4) of cases respectively. The frequency of advanced lesions among patients whose largest polyp was diminutive, small, sub-centimetre and large in size was 0.9%, 4.9%, 1.7% and 73.5% respectively. Conclusions, Based on this systematic review, a 6-mm polyp size threshold for polypectomy referral would identify over 95% of subjects with advanced adenomas, whereas a 10-mm threshold would identify 88% of cases. Aliment Pharmacol Ther,31, 210,217 [source] Prevalence and risk of colorectal adenoma in asymptomatic Koreans aged 40,49 years undergoing screening colonoscopyJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 3 2010Su Jin Chung Abstract Background and Aim:, Colorectal cancer screening is recommended for average-risk persons beginning at age 50. However, information about the incidence and risk factors of precursor adenoma in preceding decades is limited. The aim of this study was to determine the prevalence and risk factors of colorectal adenoma in persons aged 40,49 years and to compare the data with those aged 30,39 years and 50,59 years. Methods:, A cross-sectional study of 5254 asymptomatic subjects who underwent screening colonoscopy was conducted. Data were stratified by age into three groups: 608 aged 30,39 years, 1930 aged 40,49 years, and 2716 aged 50,59 years. Results:, Prevalence of overall adenomas was 10.4% in the 30,39 years age group, 22.2% in the 40,49 years age group, and 32.8% in the 50,59 years age group. Advanced adenoma was found in 0.7% of the 30,39 years age group, 2.7% of the 40,49 years age group, and 4.1% of the 50,59 years age group. In the 40,49 years age group, male sex and current smoking habits showed associations with low-risk adenoma after multiple adjustments. Moreover, male sex (odds ratio [OR] = 1.55, 95% confidence interval [CI]: 1.02,3.23), current smoking (OR = 1.58, 95%CI: 1.06,3.50), and family history of colorectal cancer (OR = 2.54, 95%CI: 1.16,5.56) were independent predictors of advanced adenoma in this age group. Conclusions:, Prevalence of adenoma in subjects aged 40,49 years was higher than in previous studies. Male sex and current smoking habits along with a family history of colorectal cancer were associated with advanced adenoma in this age group. [source] Yield from colonoscopic screening in people with a strong family history of common colorectal cancerJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 8 2000Damian J Dowling Abstract Background and Aims: People with a strong family history of common (so-called ,sporadic') colorectal cancer are generally advised to undergo colonoscopic screening, but the starting age for this is unclear. An audit was performed to study the age-related yield of screening colonoscopy in this risk group. Methods: A prospective audit of the outcome of screening colonoscopy was performed on a cohort of 232 people with a strong family history of common colorectal cancer. All were registrants in a familial bowel cancer service solely because of their family medical history. They had no bowel symptoms and no prior endoscopic investigation of the large bowel. Results: Neoplastic lesions were detected by using colonoscopy in 33 participants. In 27 participants, the major lesion was a small tubular adenoma, four had an advanced adenoma and two had cancer. More neoplastic (P = 0.02) and advanced neoplastic (P = 0.03) lesions were found in those patients aged , 50 years. Only one advanced adenoma was detected in a participant below the age of 50 years. Conclusion: The yield from screening colonoscopy in young people (< 50 years) with a strong family history of common colorectal cancer is low, placing doubt on the need for colonoscopic screening before the age of 50 years. [source] Increased Incidence of Colorectal Malignancies in Renal Transplant Recipients: A Case Control StudyAMERICAN JOURNAL OF TRANSPLANTATION, Issue 9 2010J. M. Park This study was to evaluate the frequency of colorectal neoplasia in renal transplant recipients and to investigate the association with Epstein-Barr virus (EBV) and cytomegalovirus (CMV) infection. We compared the frequency of colorectal neoplasia among renal transplant recipients with that of the healthy subjects. Specimens of colorectal neoplasia were examined for EBV and CMV using in situ hybridization and immunohistochemistry, respectively. Of 796 renal transplantation cohorts, 315 were enrolled. The frequency of colorectal neoplasia among the patients was 22.9%. Compared with the healthy subjects, the odds ratio (OR) for advanced adenoma was 3.32 (95% CI, 1.81,6.10). The frequency of cancer among the patients was 1.9% (OR, 12.0; 95% CI, 1.45,99.7). A long interval between transplantation and colonoscopy was a significant factor in the development of advanced colorectal neoplasia. EBV positivity was detected in 30.6% of colorectal neoplasia specimens from renal transplant recipients, which was higher than that for the controls (p = 0.002). CMV was not detected in any lesions of patients or controls. In conclusion, renal transplant recipients have a significantly increased risk of advanced colorectal neoplasia. EBV was more frequently found in specimens of advanced colorectal neoplasm obtained from the renal transplant recipients. [source] Plasma microRNAs are promising novel biomarkers for early detection of colorectal cancerINTERNATIONAL JOURNAL OF CANCER, Issue 1 2010Zhaohui Huang Abstract MicroRNA (miRNA) opens up a new field for molecular diagnosis of cancer. However, the role of circulating miRNAs in plasma/serum in cancer diagnosis is not clear. The aim of this study was to investigate whether plasma miRNAs can be used as biomarkers for the early detection of colorectal carcinoma (CRC). We measured the levels of 12 miRNAs (miR-134, ,146a, ,17-3p, ,181d, ,191, ,221, ,222, ,223, ,25, ,29a, ,320a and ,92a) in plasma samples from patients with advanced colorectal neoplasia (carcinomas and advanced adenomas) and healthy controls using real-time RT-PCR. We found that plasma miR-29a and miR-92a have significant diagnostic value for advanced neoplasia. MiR-29a yielded an AUC (the areas under the ROC curve) of 0.844 and miR-92a yielded an AUC of 0.838 in discriminating CRC from controls. More importantly, these 2 miRNAs also could discriminate advanced adenomas from controls and yielded an AUC of 0.769 for miR-29a and 0.749 for miR-92a. Combined ROC analyses using these 2 miRNAs revealed an elevated AUC of 0.883 with 83.0% sensitivity and 84.7% specificity in discriminating CRC, and AUC of 0.773 with 73.0% sensitivity and 79.7% specificity in discriminating advanced adenomas. Collectively, these data suggest that plasma miR-29a and miR-92a have strong potential as novel noninvasive biomarkers for early detection of CRC. [source] | ||||||||||