title: Clinical significance of colonoscopic examination in patients with early stage of gastric neoplasm undergoing endoscopic submucosal dissection.
abstract: OBJECTIVE
  We aimed to determine the frequency of colorectal neoplasm in patients with early gastric neoplasm who underwent endoscopic submucosal dissection (ESD) compared to healthy controls and to investigate their risk factors for colorectal neoplasm.
  
  
  METHODS
  A total of 107 patients with gastric neoplasm including 54 gastric adenoma and 53 early gastric cancer (EGC) that underwent ESD and 107 sex/age-matched healthy controls were enrolled. All of the subjects underwent colonoscopy for routine check-up. High-risk colorectal neoplasm were defined as >1 cm, three or more polyps, adenoma with villous component, adenoma with high-grade dysplasia or adenocarcinoma.
  
  
  RESULTS
  The frequency of overall colorectal neoplasm was 56.1% in the gastric neoplasm group and 34.6% in the control group (p < 0.005). High-risk colorectal neoplasm was found in 26.2% of patients with gastric neoplasm and 12.1% of controls (p < 0.01). In each gastric adenoma and EGC subgroups, the frequency of overall colorectal neoplasm was higher than each control subgroup. The frequency of high-risk colorectal neoplasm in EGC subgroup was significantly higher than that in the control subgroup, against not being in gastric adenoma subgroup. The risk factors for overall colorectal neoplasm were age and presence of gastric neoplasm, and that for high risk colorectal neoplasm was the only presence of gastric neoplasm.
  
  
  CONCLUSIONS
  The frequency of overall and high-risk colorectal neoplasm in the gastric neoplasm group was higher than that in the control group. Therefore, a screening colonoscopy should be considered in patients with early gastric neoplasm undergoing ESD.
authors: Department of Internal Medicine, Digestive Disease Center, Konkuk University School of Medicine, Konkuk University Medical Center, Seoul, Korea.
authors: Kyung-Ju
authors: KJ
authors: Lee
authors: Jeong Hwan
authors: JH
authors: Kim
authors: So-I
authors: SI
authors: Kim
authors: Joo-Hyun
authors: JH
authors: Jang
authors: Hak-Hyun
authors: HH
authors: Lee
authors: Sung Noh
authors: SN
authors: Hong
authors: Sun-Young
authors: SY
authors: Lee
authors: In-Kyung
authors: IK
authors: Sung
authors: Hyung Seok
authors: HS
authors: Park
authors: Chan Sub
authors: CS
authors: Shim
authors: Hye Seung
authors: HS
authors: Han
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology; D000236:Adenoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D000367:Age Factors; D000368:Aged; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000473:pathology; D004210:Dissection; D005260:Female; D005753:Gastric Mucosa / Q000601:surgery; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis* / Q000473:pathology; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000601:surgery*