BACKGROUND: The incidence of young-onset colorectal cancer (CRC) is reported to be increasing in the Western world. There are no population-based studies assessing the trend across Asia. METHODS: We performed a multinational cohort study involving four Asian countries/regions, namely Taiwan, Korea, Japan, and Hong Kong. The magnitude and direction of trend in the incidence of young-onset CRC (age < 50) were quantified using Joinpoint Regression Program to estimate average annual percentage change (AAPC). RESULTS: In Taiwan (1995–2014), incidence of young-onset CRC significantly increased in both men (colon cancer: 4.9–9.7 per 100,000; rectal cancer: 4.0–8.3 per 100,000) and women (colon cancer: 5.1–9.7 per 100,000; rectal cancer: 3.8–6.4 per 100,000). In Korea (1999–2014), incidence of young-onset CRC significantly increased in both men (colon cancer: 5.0–10.4 per 100,000; rectal cancer: 4.9–14.0 per 100,000) and women (colon cancer: 4.1–9.6 per 100,000; rectal cancer: 4.1–9.1 per 100,000). The most pronounced change was observed with male rectal cancer, increasing by 3.9% per year in Taiwan (AAPC + 3.9, 95% confidence interval + 3.3 to +4.5, P < 0.05) and 6.0% per year in Korea (AAPC +6.0, 95% confidence interval + 4.5 to +7.6, P < 0.05). Only a significant increase in rectal cancer was noted in Japan (male rectal cancer: 7.2–10.1 per 100,000, female rectal cancer 4.7–6.7 per 100,000) and Hong Kong (male rectal cancer: 4.4–7.0 per 100,000). CONCLUSIONS: Increasing trend in young-onset CRC is not limited to the Western world. This finding may have implications on screening program for CRC in these countries/regions.

No abstract

Properly designed empirical therapy, based on medication history, is an acceptable alternative to genotypic resistance-guided therapy for eradication of refractory H pylori infection after consideration of accessibility, cost, and patient preference. ClinicalTrials.gov ID: NCT01725906.

The majority of LSTs are non-invasive at the time of colonoscopic detection and can be treated with (piecemeal) endoscopic mucosal resection. Pretreatment diagnosis of endoscopic subtype, specifying areas of concern (nodule or depression), determines those LSTs at highest risk of containing SMI, where en bloc resection is the preferred therapy.

No abstract