Original Article
Clinical Endoscopy
Colorectal neoplasm in asymptomatic Asians: a prospective multinational multicenter colonoscopy survey

https://doi.org/10.1016/j.gie.2006.12.065Get rights and content

Background

Colorectal neoplasm is rapidly increasing in Asia, but a guideline for screening is not available.

Objective

To evaluate the characteristics of colorectal neoplasm in asymptomatic Asian subjects.

Setting

Multinational multicenters, including both primary and referral centers in Asia.

Patients

A total of 860 consecutive asymptomatic adults undergoing screening colonoscopy in 11 Asian cities from July 2004 to December 2004. Patients under 16 years old; those patients with a colorectal resection history, colonoscopies, or barium enema within 5 years; symptoms suggestive of colorectal diseases; and those who had undergone surveillance colonoscopy were excluded.

Main Outcome Measurements

The incidence and distribution of colorectal neoplasm and advanced neoplasm.

Results

The mean age (±SD) was 54.4 ± 11.6 years; 471 were men (54.8%). The prevalence of colorectal neoplasm and advanced neoplasm was 18.5% and 4.5%, respectively. Male sex, advancing age, and a family history of colorectal cancer were risk factors for advanced neoplasm. Of the 168 patients with colorectal neoplasm, 76 had distal neoplasm only (45.2%), 66 had proximal neoplasm only (39.3%), and 26 had both proximal and distal neoplasms (15.5%). Although the presence of distal advanced neoplasm was a significant risk factor for proximal advanced neoplasm, 14 of the 758 subjects without distal neoplasm had proximal advanced neoplasm (1.8%).

Limitations

The small number of enrolled subjects, especially from certain ethnic groups.

Conclusions

The overall prevalence of advanced colorectal neoplasm in asymptomatic Asians is comparable with the West. Male sex, advancing age, and a family history of colorectal cancer were associated with a higher risk of advanced neoplasm.

Section snippets

Subjects

This was a pilot study to investigate the findings of colonoscopy in asymptomatic Asian subjects. We set out to conduct a prospective, multinational, multicenter study by using a database designed by the Asia Pacific Working Group for Colorectal Cancer. We aimed to include consecutive asymptomatic subjects above the age of 16 years, who were undergoing colonoscopy as a screening procedure referred to 17 centers from 11 Asian cities (Bangkok, Guangzhou, Hong Kong, Jakarta, Kuala Lumpur, Manila,

Characteristics of study population

From July 2004 to December 2004, a total of 7290 subjects underwent a colonoscopy in the 17 participating centers. There were 860 asymptomatic adults who underwent colonoscopy and were analyzed in this study. Among them, 471 were men (54.8%). The mean age (±SD) was 54.4 ± 11.6 years (range, 20-90 years). In this cohort, 565 subjects (65.7%) were 50 years or older. There were 9 ethnic groups (Chinese, Indian, Indonesian, Japanese, Korean, Malay, Filipino, Thai, and white); Korean and Chinese

Discussion

In the present study, overall colorectal neoplasm and advanced neoplasm among asymptomatic Asians were found in 18.5% and 4.5% of the studied subjects, respectively. These rates appear to be numerically lower than those observed in Western studies, in which the prevalence of overall colorectal neoplasm ranged from 20.4% to 37.5% and that of advanced neoplasm ranged from 4.9% to 10.5%.8, 11, 12 However, the figures of colonic neoplasms and advanced neoplasms are very compatible with a recent

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  • Cited by (0)

    This study was sponsored by the Asia Pacific Society of Digestive Endoscopy.

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