title: Irritable bowel syndrome and the incidence of colorectal neoplasia: a prospective cohort study with community-based screened population in Taiwan.
abstract: BACKGROUND
  We aim to report the prevalence of irritable bowel syndrome (IBS) and elucidate the influence of IBS on the incidence of colorectal neoplasm through a community-screening-based, longitudinal follow-up study.
  
  
  METHODS
  We enroled 39,384 community residents aged 40 years or older who had participated in a community-based colorectal cancer-screening programme with an immunochemical faecal occult test since 1999. We followed a cohort that was free of colorectal neoplasm (excluding colorectal neoplasm at baseline) to ascertain the incident colorectal neoplasm through each round of screening and used a nationwide cancer registry. Information on IBS was obtained by linking this screened cohort with population-based health insurance claim data. Other confounding factors were also collected via questionnaire or biochemical tests.
  
  
  RESULTS
  The overall period prevalence of IBS was 23%, increasing from 14.7% for subjects aged 40-49 years to 43.7% for those aged 70 years and more. After controlling for age, gender and family history of colorectal cancer, screenees who had been diagnosed as having IBS exhibited a significantly elevated level (21%; adjusted hazard ratio (HR)=1.21 (95% CI: 1.02-1.42)) of incident colorectal adenoma compared with those who had not been diagnosed with IBS. A similar finding was noted for invasive carcinoma; however, the size of the effect was of borderline statistical significance (adjusted HR=1.20 (95% CI: 0.94-1.53)).
  
  
  CONCLUSIONS
  IBS led to an increased risk for incident colorectal neoplasm.
authors.affiliation: 1] Division of Gastroenterology, Department of Internal Medicine, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan [2] School of Medicine, Fu Jen Catholic University, Taipei, Taiwan.
authors.forename: H-C
authors.initials: HC
authors.lastname: Chang
authors.affiliation: School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: A M-F
authors.initials: AM
authors.lastname: Yen
authors.affiliation: Department of Health Industry Management, Kainan University, Tao-Yuan, Taiwan.
authors.forename: J C-Y
authors.initials: JC
authors.lastname: Fann
authors.affiliation: Department and Graduate Institute of Health Care Management, Chang Gung University, Kwei-Shan, Tao-Yuan, Taiwan.
authors.forename: S Y-H
authors.initials: SY
authors.lastname: Chiu
authors.affiliation: Young and Health Clinic, Taipei, Taiwan.
authors.forename: C-S
authors.initials: CS
authors.lastname: Liao
authors.affiliation: Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
authors.forename: H-H
authors.initials: HH
authors.lastname: Chen
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
authors.forename: K-C
authors.initials: KC
authors.lastname: Yang
authors.affiliation: School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: L-S
authors.initials: LS
authors.lastname: Chen
authors.affiliation: 1] Division of Gastroenterology, Department of Internal Medicine, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan [2] School of Medicine, Fu Jen Catholic University, Taipei, Taiwan.
authors.forename: Y-M
authors.initials: YM
authors.lastname: Lin
mesh_terms: D000368:Aged; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D043183:Irritable Bowel Syndrome / Q000453:epidemiology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012306:Risk; D013624:Taiwan / Q000453:epidemiology