Disparities in prevalence, location, and shape characteristics of colorectal neoplasia between South Korean and U.S. patients

Myung, Jae; Kozarek, Richard A.; Selva, Danielle La; Glück, Michael; Ross, Andrew; Chiorean, Michael; Koch, Johannes; Lin, Otto S.

doi:10.1016/j.gie.2015.04.018

Cited by 14 publications

(11 citation statements)

References 44 publications

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“…They are likely to be highly-motivated for their health for any number of reasons. In addition, South Koreans show disparities in prevalence, location, and shape characteristic of colorectal neoplasia compared to Westerners [42]. Thus, generalizability to other populations needs to be demonstrated.…”

Section: Discussionmentioning

confidence: 99%

Metabolically-healthy obesity is associated with higher prevalence of colorectal adenoma

Sinn

Son

et al. 2017

PLoS ONE

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BackgroundThe risk of colorectal adenoma (CRA), an important precursor of colorectal cancer, is largely unknown among obese individuals without obesity-related metabolic abnormalities, a condition described as metabolically-healthy obese (MHO). The aim of this study was to examine the association among metabolic status, the different categories of body mass index (BMI), and CRA in a large cohort of adults.MethodsWe analyzed the association among metabolic status, BMI categories and CRA in asymptomatic adults who underwent a first-time colonoscopy as part of the comprehensive health check-up program at the Health Promotion Center of Samsung Medical Center, from January 2005 to December 2012. Being metabolically healthy was defined as lacking any metabolic syndrome components and having a homeostasis model assessment of insulin resistance <2.5.ResultsThe prevalence of “any,” “multiple,” and “high-risk” CRA was 25.6%, 8.3%, and 4.4% among 9,182 metabolically-healthy participants, and 35.9%, 12.5%, and 7.0% among 17,407 metabolically-unhealthy participants, respectively. Increased BMI showed a significant dose-dependent relationship with the prevalence of “any,” “multiple,” and “high-risk” CRA, in both metabolically-healthy and unhealthy participants. In multivariable-adjusted models that accounted for potential confounders including age, sex, smoking, alcohol, first-degree family history of colorectal cancer, and aspirin use, the odds ratio (OR) for any CRA comparing MHO with metabolically-healthy normal-weight (MHNW) participants was 1.25 (95% confidence interval (CI), 1.09–1.43). Further adjustment for metabolic components associated with obesity did not significantly change the association. Similarly, the ORs for multiple CRAs and high risk CRA were higher in MHO participants than MHNW participants [ORs (95% CI), 1.63 (1.31–2.04) and 1.53 (1.14–2.04), respectively].ConclusionsThe MHO phenotype was closely associated with higher prevalence of CRA, including high-risk adenoma. This finding supports the conclusion that MHO increases the risk of colorectal cancer.

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Section: Discussionmentioning

confidence: 99%

Metabolically-healthy obesity is associated with higher prevalence of colorectal adenoma

Sinn

Son

et al. 2017

PLoS ONE

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“…[ 5 ] Currently, little is known about ethnic disparities in the prevalence of colorectal neoplasia on diagnostic colonoscopy (especially in young patients) aside from knowledge already gained by screening colonoscopy. [ 6 , 7 ]…”

Section: Introductionmentioning

confidence: 99%

Comparative analysis of diagnostic colonoscopy in symptomatic young adults from South Korea and the United States

et al. 2017

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To date, not much is known about ethnic differences in the prevalence of colorectal neoplasia in symptomatic young patients with lower gastrointestinal symptoms. This study sought to compare diagnostic colonoscopic findings in symptomatic young patients from South Korea and the United States. Results from the first diagnostic colonoscopies in symptomatic 18- to 49-year-old patients were compared between the United States and Korean cohorts. The US cohort data were collected at Virginia Mason Medical Center in Seattle, Washington between January 2007 and January 2010, and the Korean cohort data were collected at 14 university hospitals in Korea between June 2006 and June 2015.The prevalence of advanced neoplasias was similar in both cohorts for bleeding and nonbleeding symptoms (P = .966 and P = .076, respectively). In a subgroup analysis for 40- to 49-year-old patients, the prevalence of advanced neoplasias was similar for bleeding symptoms; however, nonbleeding symptoms were significantly higher in the Korean cohort than in the US cohort (6.2% vs 2.6%, P < .001). In an age subgroup analysis for 18- to 39-year-old patients, the prevalence of advanced neoplasias was similar for bleeding and nonbleeding symptoms in both cohorts. Multivariate analysis showed that lower gastrointestinal symptoms were not associated with the risk of any type of advanced neoplasia in young Korean patients.Ethnic disparities in the prevalence of advanced neoplasia on diagnostic colonoscopy were not noticeable between Korean and US young patients. However, 40- to 49-year-old patients with nonbleeding symptoms require more attention to detect advanced neoplasia in Korea than similarly aged patients in the United States.

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“…In addition, South Koreans show disparities in prevalence, location and shape characteristics of colorectal neoplasia compared to Westerners. 38 Higher prevalence of adenoma has been reported for Black people, Hispanics than in White people. 39 Therefore, generalisability of this study to community and to other ethnicities needs to be demonstrated.…”

Section: Discussionmentioning

confidence: 97%

“…They might not be representative of general population with average risk. In addition, South Koreans show disparities in prevalence, location and shape characteristics of colorectal neoplasia compared to Westerners . Higher prevalence of adenoma has been reported for Black people, Hispanics than in White people .…”

Section: Discussionmentioning

confidence: 99%

Non‐alcoholic fatty liver diseases and risk of colorectal neoplasia

Ahn

Sinn

et al. 2016

Aliment Pharmacol Ther

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Summary Background Non‐alcoholic fatty liver disease (NAFLD) is associated with colorectal neoplasia. Yet, NAFLD ranges from simple steatosis to steatohepatitis with advanced fibrosis. Aim To investigate the risk of colorectal neoplasia according to the presence and severity of NAFLD. Methods A total of 26 540 asymptomatic adults who underwent same day first‐time colonoscopy and abdominal ultrasonography as a health check‐up programme were analysed. NAFLD was diagnosed by ultrasonography. Advanced colorectal neoplasia was defined as an invasive cancer or adenoma that was at least 10 mm in diameter, had high‐grade dysplasia, or had villous histological characteristics or any combination thereof. Results NAFLD patients had a higher prevalence of any colorectal neoplasia (38.0% vs. 28.9%) and advanced colorectal neoplasia (2.8% vs. 1.9%) compared to those without NAFLD. In a multivariable model adjusted for age, sex, smoking, alcohol, body mass index, first‐degree family history of colorectal cancer, aspirin use and metabolic factors, the odd ratios comparing patients with NAFLD to those without were 1.10 [95% confidence interval (CI): 1.03–1.17] for any colorectal neoplasia and 1.21 (95% CI: 0.99–1.47) for advanced colorectal neoplasia. When NAFLD patients were further stratified according to the non‐invasive parameters of liver disease severity, the risk of any colorectal neoplasia or advanced colorectal neoplasia was higher for those with severe liver diseases than those with mild liver diseases. Conclusions The presence and severity of NAFLD were closely associated with any colorectal neoplasia and advanced colorectal neoplasia, suggesting that clinicians should be aware of the increased risk of colorectal neoplasia in patients with NAFLD.

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Disparities in prevalence, location, and shape characteristics of colorectal neoplasia between South Korean and U.S. patients

Cited by 14 publications

References 44 publications

Metabolically-healthy obesity is associated with higher prevalence of colorectal adenoma

Metabolically-healthy obesity is associated with higher prevalence of colorectal adenoma

Comparative analysis of diagnostic colonoscopy in symptomatic young adults from South Korea and the United States

Non‐alcoholic fatty liver diseases and risk of colorectal neoplasia

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