title: Risk of advanced colorectal neoplasm in patients with more than 10 adenomas on index colonoscopy: A Korean Association for the Study of Intestinal Diseases (KASID) study.
abstract: OBJECTIVE
  The number of patients with >10 adenomas is relatively small, and few studies have investigated the risk of colorectal neoplasm (CRN) in these patients. Thus, we aimed to investigate the risk of developing CRN in patients with >10 adenomas and to compare their risk with that of patients with 3-10 adenomas.
  
  
  METHODS
  A retrospective multicenter cohort study that included 214 patients with >10 adenomas on index colonoscopy performed between January 2009 and December 2011, and underwent follow-up colonoscopy until December 2015 was conducted. The risk of developing advanced CRN (cancer or advanced adenoma with a diameter of ≥10 mm or with a villous component, or high-grade dysplasia) was investigated and compared with that in patients with 3-10 adenomas (n = 975).
  
  
  RESULTS
  Among the 214 patients with >10 adenomas, the mean age was 62.9 years and the mean number of adenomas on index colonoscopy was 14.2. Overall, 57 patients (26.6%) developed an advanced CRN after a mean of 4.3 years from baseline colonoscopy. The respective 3- and 5-year cumulative risks of advanced CRN were 6.8% (95% confidence interval [CI] 2.9-10.7) and 28.7% (95% CI 20.8-36.5), higher than those in the group with 3-10 adenomas (n = 975, P = 0.001). Having >10 adenomas on index colonoscopy was an independent risk factor for developing advanced CRN (odds ratio 2.25, 95% CI 1.49-3.38).
  
  
  CONCLUSIONS
  The risk of developing advanced CRN in patients with >10 adenomas was high and statistically higher than that in patients with 3-10 adenomas. Further prospective studies are needed to investigate whether a more intensive surveillance is needed in this group.
authors: Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Soo-Kyung
authors: SK
authors: Park
authors: Department of Gastroenterology, University of Ulsan College of Medicine Asan Medical Center, Seoul, Korea.
authors: Sung Wook
authors: SW
authors: Hwang
authors: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.
authors: Kyeong Ok
authors: KO
authors: Kim
authors: Department of Internal Medicine, Kyung Hee University Hospital at Gang Dong, Kyung Hee University School of Medicine, Seoul, Korea.
authors: Jae Myung
authors: JM
authors: Cha
authors: Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea.
authors: Sun-Jin
authors: SJ
authors: Boo
authors: Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea.
authors: Jeong Eun
authors: JE
authors: Shin
authors: Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
authors: Young-Eun
authors: YE
authors: Joo
authors: Division of Gastroenterology, Soonchunhyang University College of Medicine, Cheonan, Korea.
authors: Yunho
authors: Y
authors: Jung
authors: Department of Internal Medicine, Chosun University College of Medicine, Gwangju, Korea.
authors: Jun
authors: J
authors: Lee
authors: Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Hyo-Joon
authors: HJ
authors: Yang
authors: Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Dong Il
authors: DI
authors: Park
mesh_terms: D000236:Adenoma / Q000209:etiology* / Q000473:pathology* / Q000601:surgery; D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000209:etiology* / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012306:Risk; D013997:Time Factors
keywords: adenoma; colorectal; surveillance