J Cancer Prev.  2017 Sep;22(3):159-165. 10.15430/JCP.2017.22.3.159.

Comparison of Colonoscopy Surveillance Outcomes Between Young and Older Colorectal Cancer Patients

Affiliations
  • 1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. Taeilkim@yuhs.ac
  • 2Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
  • 3Cancer Prevention Center, Yonsei University College of Medicine, Seoul, Korea.

Abstract

BACKGROUND
Young-onset colorectal cancer is uncommon, but the incidence is increasing. Despite several guidelines for colonoscopic surveillance following colorectal cancer resection, there is little consistency regarding the timing and age-adjusted strategies of surveillance colonoscopy after surgery of young-onset colorectal cancer. The aim of this study was to compare the outcomes of surveillance colonoscopy between sporadic colorectal cancer patients with young and older age after curative resection.
METHODS
We retrospectively reviewed 569 colorectal cancer patients who underwent curative resection between January 2006 and December 2010. The primary outcome was comparison of the development of metachronous advanced neoplasia during surveillance colonoscopy between young and older colorectal cancer patients.
RESULTS
There were 95 patients in the young age group and 474 patients in the older age group. The mean time interval from surgery to the development of metachronous advanced neoplasia was 99.2 ± 3.7 months in the young age group and 84.4 ± 2.5 months in the old age group (P = 0.03). In the multivariate analysis, age (OR, 3.56; P = 0.04) and family history of colorectal cancer (OR, 2.66; P = 0.008) were associated with the development of metachronous advanced neoplasia. None of the young patients without both family history of colorectal cancer and high-risk findings at index colonoscopy showed advanced neoplasia during the follow-up period.
CONCLUSIONS
Age and family history of colorectal cancer are independent risk factors for the occurrence of advanced neoplasia after curative colorectal cancer resection, suggesting age-adjusted strategies of surveillance colonoscopy.

Keyword

Surveillance; Colonoscopy; Colorectal neoplasms; Age of onset

MeSH Terms

Age of Onset
Colonoscopy*
Colorectal Neoplasms*
Follow-Up Studies
Humans
Incidence
Multivariate Analysis
Retrospective Studies
Risk Factors
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