The prevalence of colorectal adenomas in asymptomatic Korean men and women.
BACKGROUND
Colorectal cancer incidence is rapidly rising in many Asian countries, with rates approaching those of Western countries. This study aimed to evaluate the prevalence and trends of colorectal adenomas by age, sex, and risk strata in asymptomatic Koreans.


METHODS
Cross-sectional study of 19,372 consecutive participants aged 20 to 79 years undergoing screening colonoscopy at the Center for Health Promotion of the Samsung Medical Center in Korea from January 2006 to June 2009.


RESULTS
Among participants at average risk, those without a history of colorectal polyps or a family history of colorectal cancer, the prevalence of colorectal adenomas and advanced adenomas were 34.5% and 3.1%, respectively, in men and 20.0% and 1.6%, respectively, in women. The prevalence of adenomas increased with age in both men and women, with a more marked increase for advanced adenoma. Participants with a family history of colorectal cancer or with a history of colorectal polyps had significantly higher prevalence of adenomas compared with participants of average risk (36.9% vs. 26.9%; age- and sex-adjusted prevalence ratio = 1.16; 95% confidence interval, 1.09-1.22). The prevalence of adenomas increased annually in both men and women.


CONCLUSIONS
In this large study of asymptomatic Korean men and women participating in a colonoscopy screening program, the prevalence of colorectal adenomas was comparable and possibly higher than previously reported in Western countries.


CONCLUSIONS
Cost-effectiveness studies investigating the optimal age for starting colonoscopy screening and etiological studies to identify the reasons for the increasing trend in colorectal adenomas in Koreans are needed.
Authors' Affiliations: Center for Health Promotion, Samsung Medical Center; Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine; and Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea; Department of Social and Preventive Medicine, Julius Centre University of Malaya, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; and Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland.
Moon Hee
MH
Yang
Sanjay
S
Rampal
Jidong
J
Sung
Yoon-Ho
YH
Choi
Hee Jung
HJ
Son
Jun Haeng
JH
Lee
Young-Ho
YH
Kim
Dong Kyung
DK
Chang
Poong-Lyul
PL
Rhee
Jong Chul
JC
Rhee
Eliseo
E
Guallar
Juhee
J
Cho
D000236:Adenoma / Q000453:epidemiology*; D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D055815:Young Adult