Colorectal neoplasm in asymptomatic Asians: a prospective multinational multicenter colonoscopy survey

BackgroundColorectal neoplasm is rapidly increasing in Asia, but a guideline for screening is not available.ObjectiveTo evaluate the characteristics of colorectal neoplasm in asymptomatic Asian subjects.DesignProspective cohort study.SettingMultinational multicenters, including both primary and referral centers in Asia.PatientsA total of 860 consecutive asymptomatic adults undergoing screening colonoscopy in 11 Asian cities from July 2004 to December 2004. Patients under 16 years old; those patients with a colorectal resection history, colonoscopies, or barium enema within 5 years; symptoms suggestive of colorectal diseases; and those who had undergone surveillance colonoscopy were excluded.Main Outcome MeasurementsThe incidence and distribution of colorectal neoplasm and advanced neoplasm.ResultsThe mean age (±SD) was 54.4 ± 11.6 years; 471 were men (54.8%). The prevalence of colorectal neoplasm and advanced neoplasm was 18.5% and 4.5%, respectively. Male sex, advancing age, and a family history of colorectal cancer were risk factors for advanced neoplasm. Of the 168 patients with colorectal neoplasm, 76 had distal neoplasm only (45.2%), 66 had proximal neoplasm only (39.3%), and 26 had both proximal and distal neoplasms (15.5%). Although the presence of distal advanced neoplasm was a significant risk factor for proximal advanced neoplasm, 14 of the 758 subjects without distal neoplasm had proximal advanced neoplasm (1.8%).LimitationsThe small number of enrolled subjects, especially from certain ethnic groups.ConclusionsThe overall prevalence of advanced colorectal neoplasm in asymptomatic Asians is comparable with the West. Male sex, advancing age, and a family history of colorectal cancer were associated with a higher risk of advanced neoplasm.