Colorectal neoplasia in Asia: a multicenter colonoscopy survey in symptomatic patients.
BACKGROUND
The incidence of colorectal cancer is rising rapidly in some Asian countries.


OBJECTIVE
To determine the prevalence and the distribution of colorectal neoplasm in Asian populations.


METHODS
A multicenter colonoscopy survey.


METHODS
Between July 2004 and April 2005, consecutive symptomatic patients undergoing colonoscopic examinations in 10 different Asian countries.


METHODS
The location and the histologic features of all colonic neoplasms were recorded. Advanced neoplasm was defined as adenoma larger than 10 mm in size, with >25% villous features or with high-grade dysplasia or invasive carcinoma.


METHODS
The prevalence and the distribution of colorectal neoplasm and advanced neoplasm.


RESULTS
A total of 5464 eligible patients underwent colonoscopy. Advanced neoplasm was found in 512 patients (9.4%). Factors associated with the presence of advanced neoplasm in this symptomatic Asian population included male sex (relative risk [RR] 1.52, 95% confidence interval [CI] 1.26-1.84), older age (RR 1.05, 95% CI 1.04-1.06), and ethnicity (P = .001). Advanced proximal neoplasm was detected in 136 patients (2.5%); 83 (61.0%) of the patients had normal distal colon. The RR of proximal advanced neoplasm was 2.5, 95% CI 1.7-3.7 in those with any adenoma in the distal colon compared with those with normal distal colon.


CONCLUSIONS
Possible underrepresentation of some ethnic groups because of uneven ethnic group distribution and the lack of population-based registry.


CONCLUSIONS
This was the first multicenter colonoscopy survey that examined the characteristics of colorectal neoplasm in Asia. The results will have important implications on the planning for future colorectal cancer screening in this region.
Leung
Wai K
WK
Institute of Digestive Disease and Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
Ho
Khek Yu
KY
Kim
Won-ho
WH
Lau
James Y W
JY
Ong
Euan
E
Hilmi
Ida
I
Kullavanijaya
Pinit
P
Wang
Cheng-yi
CY
Li
Chu-jun
CJ
Fujita
Rikiyu
R
Abdullah
Murdan
M
Tandon
Rakesh
R
Sung
Joseph J Y
JJ
D000236:Adenoma / Q000453:epidemiology / Q000473:pathology; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001210:Asia, Southeastern / Q000453:epidemiology; D002277:Carcinoma / Q000453:epidemiology / Q000473:pathology; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000150:complications / Q000453:epidemiology* / Q000208:ethnology / Q000473:pathology*; D003625:Data Collection; D005202:Asia, Eastern / Q000453:epidemiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D015995:Prevalence; D011446:Prospective Studies; D012107:Research Design; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors