Distribution of the Colonoscopic Adenoma Detection Rate According to Age: Is Recommending Colonoscopy Screening for Koreans Over the Age of 50 Safe?

Abstract

PurposeThis study was conducted to determine the distributions of the polyp detection rate (PDR) and the adenoma detection rate (ADR) according to age by analyzing the polypectomy results.MethodsA total of 10,098 patients who underwent a colonoscopy in 2013 were included in this study. Chi-square and logistic regression statistical analyses were performed using SPSS ver. 19.ResultsThe mean age of the patients was 52.7 years old (median, 54 ± 12.52 years; range, 14 to 92 years). A total of 6,459 adenomatous polyps (61.7%) from a total of 10,462 polyps were eliminated. The PDR was 50.9% (5,136/10,098), and the. ADR was 35.4% (3,579/10,098). The male-to-female ratio was 51.3%:48.7%, with a male-to-female ADR ratio of 42.8% : 27.7% (P < 0.001). In the age distribution, the values of the ADR were 0% for patients in their 10's, 6.3% for those in their 20's, 14.0% for those in their 30's, 28.7% for those in their 40's, 38.4% for those in their 50's, 46.2% for those in their 60's, 55.8% for those in their 70's, 56.1% for those in their 80's, and 33.3% for those in their 90's. In males, the values of the ADR were 0%, 9.1%, 17.1%, 37.8%, 48.2%, 53.6%, 61.7%, 59.1%, and 33.3% for the same age distribution, and a steep increase was found between patients in their 30's and patients in their 40's. Significant (P < 0.001) factors influencing the ADR included sex, previous colonoscopy experience, polypectomy method, and age of more than 40 years.ConclusionIn considering the adenoma carcinoma sequence, 28.7% of people, especially 37.8% of males in their 40's showed adenomatous polyps. Whether an earlier first-time colonoscopy will have better results in preventing colorectal cancer should be investigated and discussed.

Endoscopic Improvement of the Adenoma Detection Rate during Colonoscopy - Where Do We Stand in 2015?

“…Data from a large Korean cohort have shown that especially over and above the 4th decade of life, the ADR reaches 28% as compared to the 2nd decade of life when it is only 14% [7]. Comparable results were published in a large European register [8,9].…”

Adenoma Detection Rate in Patients Younger Than 50 Years of Age: Relationship of the Adenoma Detection Rate to Interval Cancer

“…Adenoma detection by colonoscopy depends on various factors concerning the patient, the endoscopist, and the procedure. Bae et al [ 4 ] showed an overall detection rate of 35.4%, which is similar to or a little bit higher than the values published in other reports in Korea [ 7 , 8 ]. The reason for the higher ADR is not clear.…”

“…The authors of "Distribution of the Colonoscopic Adenoma Detection Rate According to Age: Is Recommending Colonoscopy Screening for Koreans Over the Age of 50 Safe?" cautiously suggest an earlier first-time colonoscopy based on the higher adenoma detection rate for males in their 40's [ 4 ].…”

High prevalence of advanced colorectal neoplasia in the Thai population: a prospective screening colonoscopy of 1,404 cases

“…These patients should receive therapeutic intervention before progression to more advanced disease. When we excluded the amount criteria from the high risk adenoma group, the prevalence of advanced colorectal neoplasia in our study (3 %) and also adenocarcinoma (1.3 %) were still comparable to the country with a high incidence of colorectal cancer [14, 15]. Prior hospital-based reports and retrospective studies from Thailand also showedcancer detection rate by colonoscopy of 0.6–7.1 % in different studied population [7–9, 16, 17].…”