title: Do we need colonoscopy in patients with gastric adenomas? The risk of colorectal adenoma in patients with gastric adenomas.
abstract: BACKGROUND
  Gastric polyps are found frequently in various colonic polyposis syndromes. Genetic alterations of several genes occur in gastric adenomas and colorectal adenomas. However, it is unknown whether patients with gastric adenomas are at higher risk for colorectal adenomas.
  
  
  OBJECTIVE
  To investigate the prevalence rate of colorectal adenoma in patients with gastric adenomas and to determine the association between the presence of gastric adenomas and synchronous colorectal adenomas.
  
  
  METHODS
  A retrospective, cross-sectional, case-control study.
  
  
  METHODS
  Single center: Center for Health Promotion of Samsung Medical Center.
  
  
  METHODS
  This study involved 87 patients with gastric adenomas and 174 sex-matched and age-matched controls among 19,019 participants who underwent EGD and colonoscopy simultaneously or within 6 months of each other from January 2001 to December 2008 at the Center for Health Promotion of Samsung Medical Center.
  
  
  METHODS
  EGD and colonoscopy.
  
  
  METHODS
  The prevalence rate of colorectal adenoma in patients with gastric adenomas.
  
  
  RESULTS
  The 87 gastric adenoma patients included 72 men and 15 women. Colorectal adenomas were identified in 42 (48.3%) of 87 cases and in 58 (33.3%) of 174 controls (P = .022). The prevalence of colorectal adenoma was significantly higher in the gastric adenoma group than in the control group. The mean size and number of colorectal adenomas were not significantly different between the two groups. The majority of colorectal adenomas were located in distal colonic segments in the gastric adenoma group in contrast with proximal colonic segments in the control group. Multivariate logistic regression analysis revealed that independent risk factors for colorectal adenoma were the presence of gastric adenomas (odds ratio [OR], .915; 95% confidence interval [CI], 1.044-3.513) and increasing age over 55 years (OR, 2.943; 95% CI, 1.558-5.560).
  
  
  CONCLUSIONS
  Lack of data on previous colorectal adenomas and possible confounding factors such as hyperlipidemia or diabetes mellitus.
  
  
  CONCLUSIONS
  The risk of colorectal adenoma increases significantly in patients with gastric adenomas and in patients over age 55. A screening colonoscopy may be necessary for patients with gastric adenomas to detect colorectal adenomas.
authors.affiliation: Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Moon Hee
authors.initials: MH
authors.lastname: Yang
authors.forename: Hee Jung
authors.initials: HJ
authors.lastname: Son
authors.forename: Jun Haeng
authors.initials: JH
authors.lastname: Lee
authors.forename: Min Hyung
authors.initials: MH
authors.lastname: Kim
authors.forename: Jin Yong
authors.initials: JY
authors.lastname: Kim
authors.forename: Young-Ho
authors.initials: YH
authors.lastname: Kim
authors.forename: Dong Kyung
authors.initials: DK
authors.lastname: Chang
authors.forename: Poong-Lyul
authors.initials: PL
authors.lastname: Rhee
authors.forename: Jae J
authors.initials: JJ
authors.lastname: Kim
authors.forename: Jong Chul
authors.initials: JC
authors.lastname: Rhee
mesh_terms: D000236:Adenoma / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D000328:Adult; D000367:Age Factors; D000368:Aged; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D003430:Cross-Sectional Studies; D005260:Female; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D016017:Odds Ratio; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology / Q000601:surgery