Do we need colonoscopy in patients with gastric adenomas? The risk of colorectal adenoma in patients with gastric adenomas.
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.
Yang
Moon Hee
MH
Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Son
Hee Jung
HJ
Lee
Jun Haeng
JH
Kim
Min Hyung
MH
Kim
Jin Yong
JY
Kim
Young-Ho
YH
Chang
Dong Kyung
DK
Rhee
Poong-Lyul
PL
Kim
Jae J
JJ
Rhee
Jong Chul
JC
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