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Annals of Surgical Oncology

, Volume 20, Issue 5, pp 1614–1622 | Cite as

Role of Preoperative Colonoscopy in Patients with Gastric Cancer: A Case Control Study of the Prevalence of Coexisting Colorectal Neoplasms

  • Han Mo Yoo
  • Tae Geun Gweon
  • Ho Seok Seo
  • Jung Ho Shim
  • Sung Il Oh
  • Myung Gyu Choi
  • Kyo Young Song
  • Hae Myoung Jeon
  • Cho Hyun ParkEmail author
Gastrointestinal Oncology

Abstract

Background

We evaluated the prevalence of coexisting asymptomatic colorectal neoplasm (CRN) in patients with gastric cancer (GC).

Methods

Preoperative colonoscopic examinations were performed in 495 patients with GC who underwent gastrectomy between January 2009 and December 2010. To compare the prevalence of CRN in these patients with that in a normal population, we selected 495 sex- and age-matched persons who underwent colonoscopies for health screening. Risk factors for CRN were evaluated by univariate and multivariate analyses.

Results

The overall incidence of CRN was 41.8 % (414/990). The prevalence of overall CRN, high-risk CRN, and colorectal carcinoma (CRC) were significantly higher in the GC group than in the control group (overall CRN: 48.9 % vs. 34.7 %; high-risk CRN: 28.3 % vs. 13.5 %; CRC: 2.6 % vs. 0.2 %; all P < 0.001). The presence of GC [odds ratio (OR), 1.82; 95 % confidence interval (CI), 1.4–2.38; P < 0.001], age ≥50 years (OR, 2.58; 95 % CI, 1.75–3.81; P < 0.001), and male sex (OR, 2.28; 95 % CI, 1.72–3.02; P < 0.001) were risk factors for overall CRN. In patients with GC, age ≥40 years (OR, 3.22; 95 % CI, 1.24–8.37; P = 0.016) and male sex (OR, 3.21; 95 % CI, 2.17–4.76; P < 0.001) were risk factors for overall CRN.

Conclusions

The prevalence of coexisting CRN, including CRC, was higher in patients with GC than in the normal population. Preoperative colonoscopy is strongly indicated in patients with GC who are male and/or ≥40 years of age.

Keywords

Gastric Cancer Adenoma Pylorus Infection Endoscopic Submucosal Dissection Early Gastric Cancer 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Disclosure

No disclosure of any commercial, financial, or material support.

References

  1. 1.
    Pisani P, Parkin DM, Ferlay J. Estimates of the worldwide mortality from eighteen major cancers in 1985. Implications for prevention and projections of future burden. Int J Cancer. 1993;55:891–903.PubMedCrossRefGoogle Scholar
  2. 2.
    Parkin DM, Bray FI, Devesa SS. Cancer burden in the year 2000. The global picture. Eur J Cancer. 2001;37(Suppl 8):S4–66.CrossRefGoogle Scholar
  3. 3.
    Parkin DM. International variation. Oncogene. 2004;23:6329–40.PubMedCrossRefGoogle Scholar
  4. 4.
    Yokota T, Ishiyama S, Saito T, et al. Treatment strategy of limited surgery in the treatment guidelines for gastric cancer in Japan. Lancet Oncol. 2003;4:423–8.PubMedCrossRefGoogle Scholar
  5. 5.
    Park CH, Song KY, Kim SN. Treatment results for gastric cancer surgery: 12 years’ experience at a single institute in Korea. Eur J Surg Oncol. 2008;34:36–41.PubMedCrossRefGoogle Scholar
  6. 6.
    Habermann CR, Weiss F, Riecken R, et al. Preoperative staging of gastric adenocarcinoma: comparison of helical CT and endoscopic US. Radiology. 2004;230:465–71.PubMedCrossRefGoogle Scholar
  7. 7.
    Ikeda Y, Saku M, Kawanaka H, et al. Features of second primary cancer in patients with gastric cancer. Oncology. 2003;65:113–7.PubMedCrossRefGoogle Scholar
  8. 8.
    Eom BW, Lee HJ, Yoo MW, et al. Synchronous and metachronous cancers in patients with gastric cancer. J Surg Oncol. 2008;98:106–10.PubMedCrossRefGoogle Scholar
  9. 9.
    Tominaga K, Koyama Y, Sasagawa M, et al. A follow-up study of resected stomach cancer patients with special emphasis on the incidence of second primary cancers. Jpn J Clin Oncol. 1993;23:331–5.PubMedGoogle Scholar
  10. 10.
    Katai H, Sano T. Early gastric cancer: concepts, diagnosis, and management. Int J Clin Oncol. 2005;10:375–83.PubMedCrossRefGoogle Scholar
  11. 11.
    Kunisaki C, Akiyama H, Nomura M, et al. Significance of long-term follow-up of early gastric cancer. Ann Surg Oncol. 2006;13:363–9.PubMedCrossRefGoogle Scholar
  12. 12.
    Ha TK, An JY, Youn HG, et al. Surgical outcome of synchronous second primary cancer in patients with gastric cancer. Yonsei Med J. 2007;48:981–7.PubMedCrossRefGoogle Scholar
  13. 13.
    Bozzetti F, Bonfanti G, Mariani L, et al. Risk of second malignancies after surgical treatment for early gastric cancer. Gastric Cancer. 1999;2:74–5.PubMedCrossRefGoogle Scholar
  14. 14.
    Bos JL, Fearon ER, Hamilton SR, et al. Prevalence of ras gene mutations in human colorectal cancers. Nature. 1987;327:293–7.PubMedCrossRefGoogle Scholar
  15. 15.
    Vogelstein B, Fearon ER, Hamilton SR, et al. Genetic alterations during colorectal-tumor development. N Engl J Med. 1988;319:525–32.PubMedCrossRefGoogle Scholar
  16. 16.
    Winawer SJ, Zauber AG, Fletcher RH, et al. Guidelines for colonoscopy surveillance after polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer and the American Cancer Society. Gastroenterology. 2006;130:1872–85.PubMedCrossRefGoogle Scholar
  17. 17.
    Levine JS, Ahnen DJ. Clinical practice. Adenomatous polyps of the colon. N Engl J Med. 2006;355:2551–7.PubMedCrossRefGoogle Scholar
  18. 18.
    Winawer SJ, Zauber AG, Fletcher RH, et al. Guidelines for colonoscopy surveillance after polypectomy: a consensus update by the U.S. Multi-Society Task Force on Colorectal Cancer and the American Cancer Society. CA Cancer J Clin. 2006;56:143–59; quiz 184–5.PubMedCrossRefGoogle Scholar
  19. 19.
    Shiwaku K, Anuurad E, Enkhmaa B, et al. Appropriate BMI for Asian populations. Lancet. 2004;363:1077.PubMedCrossRefGoogle Scholar
  20. 20.
    Lee SS, Jung WT, Kim CY, et al. The synchronous prevalence of colorectal neoplasms in patients with stomach cancer. J Korean Soc Coloproctol. 2011;27:246–51.PubMedCrossRefGoogle Scholar
  21. 21.
    Joo MK, Park JJ, Lee WW, et al. Differences in the prevalence of colorectal polyps in patients undergoing endoscopic removal of gastric adenoma or early gastric cancer and in healthy individuals. Endoscopy. 2010;42:114–20.PubMedCrossRefGoogle Scholar
  22. 22.
    Park DI, Park SH, Yoo TW, et al. The prevalence of colorectal neoplasia in patients with gastric cancer: a Korean Association for the Study of Intestinal Disease (KASID) Study. J Clin Gastroenterol. 2010;44:102–5.PubMedCrossRefGoogle Scholar
  23. 23.
    Levi F, Randimbison L, Te VC, et al. Multiple primary cancers in the Vaud Cancer Registry, Switzerland, 1974–1989. Br J Cancer. 1993;67:391–5.PubMedCrossRefGoogle Scholar
  24. 24.
    Buiatti E, Crocetti E, Acciai S, et al. Incidence of second primary cancers in three Italian population-based cancer registries. Eur J Cancer. 1997;33:1829–34.PubMedCrossRefGoogle Scholar
  25. 25.
    Evans HS, Moller H, Robinson D, et al. The risk of subsequent primary cancers after colorectal cancer in southeast England. Gut. 2002;50:647–52.PubMedCrossRefGoogle Scholar
  26. 26.
    Teppo L, Pukkala E, Saxen E. Multiple cancer–an epidemiologic exercise in Finland. J Natl Cancer Inst. 1985;75:207–17.PubMedGoogle Scholar
  27. 27.
    Maruyama H, Hasuike Y, Furukawa J, et al. Multiple colorectal carcinomas and colorectal carcinoma associated with extracolonic malignancies. Surg Today. 1992;22:99–104.PubMedCrossRefGoogle Scholar
  28. 28.
    Arai T, Sawabe M, Takubo K, et al. Multiple colorectal cancers in the elderly: a retrospective study of both surgical and autopsy cases. J Gastroenterol. 2001;36:748–52.PubMedCrossRefGoogle Scholar
  29. 29.
    Ueno M, Muto T, Oya M, et al. Multiple primary cancer: an experience at the Cancer Institute Hospital with special reference to colorectal cancer. Int J Clin Oncol. 2003;8:162–7.PubMedCrossRefGoogle Scholar
  30. 30.
    Lim SB, Jeong SY, Choi HS, et al. Synchronous gastric cancer in primary sporadic colorectal cancer patients in Korea. Int J Colorectal Dis. 2008;23:61–5.PubMedCrossRefGoogle Scholar
  31. 31.
    Lee JH, Bae JS, Ryu KW, et al. Gastric cancer patients at high-risk of having synchronous cancer. World J Gastroenterol. 2006;12:2588–92.PubMedGoogle Scholar
  32. 32.
    Schulmann K, Reiser M, Schmiegel W. Colonic cancer and polyps. Best Pract Res Clin Gastroenterol. 2002;16:91–114.PubMedCrossRefGoogle Scholar
  33. 33.
    Meucci G, Tatarella M, Vecchi M, et al. High prevalence of Helicobacter pylori infection in patients with colonic adenomas and carcinomas. J Clin Gastroenterol. 1997;25:605–7.PubMedCrossRefGoogle Scholar
  34. 34.
    Sobhani I, Lehy T, Laurent-Puig P, et al. Chronic endogenous hypergastrinemia in humans: evidence for a mitogenic effect on the colonic mucosa. Gastroenterology. 1993;105:22–30.PubMedGoogle Scholar
  35. 35.
    Winawer S, Fletcher R, Rex D, et al. Colorectal cancer screening and surveillance: clinical guidelines and rationale-Update based on new evidence. Gastroenterology. 2003;124:544–60.PubMedCrossRefGoogle Scholar
  36. 36.
    Schoen RE, Tangen CM, Kuller LH, et al. Increased blood glucose and insulin, body size, and incident colorectal cancer. J Natl Cancer Inst. 1999;91:1147–54.PubMedCrossRefGoogle Scholar
  37. 37.
    Tabuchi M, Kitayama J, Nagawa H. Hypertriglyceridemia is positively correlated with the development of colorectal tubular adenoma in Japanese men. World J Gastroenterol. 2006;12:1261–4.PubMedGoogle Scholar
  38. 38.
    Mutoh M, Akasu T, Takahashi M, et al. Possible involvement of hyperlipidemia in increasing risk of colorectal tumor development in human familial adenomatous polyposis. Jpn J Clin Oncol. 2006;36:166–71.PubMedCrossRefGoogle Scholar
  39. 39.
    Lieberman DA, Weiss DG, Bond JH, et al. Use of colonoscopy to screen asymptomatic adults for colorectal cancer. Veterans Affairs Cooperative Study Group 380. N Engl J Med. 2000;343:162–8.PubMedCrossRefGoogle Scholar
  40. 40.
    Imperiale TF, Wagner DR, Lin CY, et al. Risk of advanced proximal neoplasms in asymptomatic adults according to the distal colorectal findings. N Engl J Med. 2000;343:169–74.PubMedCrossRefGoogle Scholar
  41. 41.
    Winawer SJ, Zauber AG, Ho MN, et al. Prevention of colorectal cancer by colonoscopic polypectomy. The National Polyp Study Workgroup. N Engl J Med. 1993;329:1977–81.PubMedCrossRefGoogle Scholar
  42. 42.
    Citarda F, Tomaselli G, Capocaccia R, et al. Efficacy in standard clinical practice of colonoscopic polypectomy in reducing colorectal cancer incidence. Gut. 2001;48:812–5.PubMedCrossRefGoogle Scholar
  43. 43.
    Winawer SJ, Zauber AG, O’Brien MJ, et al. Randomized comparison of surveillance intervals after colonoscopic removal of newly diagnosed adenomatous polyps. The National Polyp Study Workgroup. N Engl J Med. 1993;328:901–6.PubMedCrossRefGoogle Scholar
  44. 44.
    Muto T, Bussey HJ, Morson BC. The evolution of cancer of the colon and rectum. Cancer. 1975;36:2251–70.PubMedCrossRefGoogle Scholar
  45. 45.
    Eide TJ. Risk of colorectal cancer in adenoma-bearing individuals within a defined population. Int J Cancer. 1986;38:173–6.PubMedCrossRefGoogle Scholar
  46. 46.
    Winawer SJ, O’Brien MJ, Waye JD, et al. Risk and surveillance of individuals with colorectal polyps. Who Collaborating Centre for the Prevention of Colorectal Cancer. Bull World Health Organ. 1990;68:789–95.PubMedGoogle Scholar
  47. 47.
    Chung SJ, Kim YS, Yang SY, et al. Five-year risk for advanced colorectal neoplasia after initial colonoscopy according to the baseline risk stratification: a prospective study in 2452 asymptomatic Koreans. Gut. 2011;60:1537–43.PubMedCrossRefGoogle Scholar
  48. 48.
    Lee SK, Kim TI, Shin SJ, et al. Impact of prior abdominal or pelvic surgery on colonoscopy outcomes. J Clin Gastroenterol. 2006;40:711–6.PubMedCrossRefGoogle Scholar
  49. 49.
    Shah HA, Paszat LF, Saskin R, et al. Factors associated with incomplete colonoscopy: a population-based study. Gastroenterology. 2007;132:2297–303.PubMedCrossRefGoogle Scholar

Copyright information

© Society of Surgical Oncology 2013

Authors and Affiliations

  • Han Mo Yoo
    • 1
  • Tae Geun Gweon
    • 2
  • Ho Seok Seo
    • 1
  • Jung Ho Shim
    • 1
  • Sung Il Oh
    • 1
  • Myung Gyu Choi
    • 2
  • Kyo Young Song
    • 1
  • Hae Myoung Jeon
    • 1
  • Cho Hyun Park
    • 1
    Email author
  1. 1.Division of Gastrointestinal Surgery, Department of Surgery, Seoul St. Mary’s Hospital, College of MedicineThe Catholic University of KoreaSeoulKorea
  2. 2.Department of Internal Medicine, Seoul St. Mary’s Hospital, College of MedicineThe Catholic University of KoreaSeoulKorea

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