Risk factors for high-grade dysplasia or carcinoma in colorectal adenoma cases treated with endoscopic polypectomy

Manabu Kurome, Jun Kato, Toru Nawa, Tsuyoshi Fujimoto, Hiroshi Yamamoto, Junji Shiode, Masaki Wato, Kenji Kuwaki, Hiroyuki Okada, Kohsaku Sakaguchi, Yasushi Shiratori

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Abstract

OBJECTIVE: Our aim is to establish the risk factors for carrying high-grade dysplasia or carcinoma by analyzing endoscopically treated adenoma cases. METHODS: Patients who underwent endoscopic polypectomy at our hospitals between January 2003 and August 2004 were analyzed. RESULTS: A total of 889 patients (mean age: 63±11 years), and 1486 adenomas resected from these patients, were included in the analysis. Seventy-five adenomas (5%) from 72 patients (8%) were found to have high-grade dysplasia or carcinoma. Among patient factors, female sex [odds ratio (OR) 2.25, 95% confidence intervals (CI)=1.34-3.76], presence of multiple adenomas (OR=2.15, 95% CI=1.15-4.00), older age (OR=1.02, 95% CI=1.00-1.04), and rectal bleeding as the indication for colonoscopy (OR=2.57, 95% CI=1.34-4.92) were identified as the significant risk factors for carrying high-grade dysplasia or carcinoma using the multivariate analysis. In addition, a size of ≥10 mm (OR=10.83, 95% CI=5.86-20.0), flat appearance (OR=3.91, 95% CI=2.20-6.95), and location on the left side of the colon (OR=1.80, 95% CI=1.03-3.13) were identified as tumor risk factors. CONCLUSION: Distinct factors were proved to be associated with high-grade dysplasia or carcinoma. These results are useful to select lesions that require immediate treatment. Moreover, female sex as a risk factor raises an interesting problem regarding the progression from adenoma to carcinoma.

Original languageEnglish
Pages (from-to)111-117
Number of pages7
JournalEuropean Journal of Gastroenterology and Hepatology
Volume20
Issue number2
DOIs
Publication statusPublished - Feb 1 2008

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Keywords

  • Clinical risk factors
  • Colorectal adenoma
  • Endoscopic polypectomy

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Kurome, M., Kato, J., Nawa, T., Fujimoto, T., Yamamoto, H., Shiode, J., Wato, M., Kuwaki, K., Okada, H., Sakaguchi, K., & Shiratori, Y. (2008). Risk factors for high-grade dysplasia or carcinoma in colorectal adenoma cases treated with endoscopic polypectomy. European Journal of Gastroenterology and Hepatology, 20(2), 111-117. https://doi.org/10.1097/MEG.0b013e3282f1cbef