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Intestinal Research 2005;3(1):18-26.
Published online June 30, 2005.
The Characteristics of Colorectal Adenoma with Colonoscopic Polypectomy in Population under 50 Years Old: The KASID Prospective Multicenter Study
Hyun Joo Song, Sung-Ae Jung, Hyun Soo Kim, Young-Ho Kim, Won Ho Kim, Tae Il Kim, Hyo Jong Kim, Suk Kyun Yang, Seung Jae Myung, Jeong Sik Byeon, Moon Sung Lee, Il Kwon Jung, Moon Kwan Chung, Yoon Tae Jeen, Jai Hyun Choi, Hwang Choi, Dong Soo Han, Jae Suk Song
*Departments of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Yonsei University
Wonju, Sungkyunkwan University
Seoul, Yonsei University
§Seoul, Kyunghee University
Seoul, Ulsan University
Seoul, Soonchunhyang University
**Bucheon and Chonnan, Youngnam University
††Daegu, Korea University
‡‡Ansan and Seoul, Catholic University
§§Bucheon, Hanyang University
∥∥Guri, and Preventive Medicine, Kwandong University College of Medicine, Gangneung, Korea
50세 미만 인구에서 용종절제술로 제거된 대장선종의 특성: 대한장연구학회 전향적 다기관공동연구
송현주, 정성애, 김현수, 김영호, 김원호, 김태일, 김효종, 양석균, 명승재, 변정식, 이문성, 정일권, 정문관, 진윤태, 최재현, 최황, 한동수,
*이화의대, 원주의대
성균관의대
연세의대
§경희의대
울산의대
순천향의대
**영남의대
††고려의대
‡‡가톨릭의대
§§한양의대 내과학교실
∥∥관동의대 예방의학교실
Abstract
Background/Aims
The current practice of colonoscopic polypectomy reduce the risk of colorectal cancer. However, clinicopathologic charateristics of colorectal adenoma in population under 50 years old are uncertain. This study was performed to investigate clinicopathologic characteristics of colorectal adenoma and to determine colonoscopic indication of advanced adenoma in this population. Methods: A large scale, multicenter, prospective study was conducted from July 2003 through June 2004. Of the total 19,288 patients performed colonoscopy at 11 tertiary medical centers, we analysed 3,366 patients who undergone polypectomy and divided two groups by age of 50. Results: Among colonoscopic polypectomy, 10.7 percent (831/7,789) was younger patients and 22.0 percent (2.535/11,499) was older patients (p<0.001), and the detection rate of advanced adenoma was significantly lower in younger patients than older patients (17.7% vs. 21.1%, p<0.0050). In younger patients, the indications of colonoscopy were asymptomatic screening (32.7%), bowel habit change (24.0%), abdominal pain (16.8%), hematochezia (9.2%) and so on. The risk factors for advanced adenoma as colonoscopic indications in younger patients were hematochezia (OR 1.9, 95% CI 1.1-3.3) and referred patients from primary clinic (OR 2.0, 95% CI 1.3-3.0). Conclusions: This study documents lower prevalence of adenoma requiring polypectomy in younger patients compared with older patients and the low detection rate of advanced adenoma. Also, in this younger population, the colonoscopic polypectomy should be the first consideration in polyps with hamatochezia patients or referred patients from primary clinic. (Intest Res 2005;3:18-26)
Key Words: Colorectal adenoma, Colonoscopic polypectomy, Age
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