The Risk of Colorectal Adenoma in Patients with Gastric Adenomas

Abstract

Purpose: Gastric polyps are found frequently in various colonic polyposis syndromes. Genetic alterations of several genes are developed in gastric adenomas and colorectal adenomas. However, it is not established that patients with gastric adenomas are higher risk for colorectal adenomas. The aims of study were to investigate the prevalence rate of colorectal adenoma in patients with gastric adenomas and to determine the association between the presence of gastric adenomas and synchronous colorectal adenomas. Methods: We reviewed the clinical records including endoscopic findings of 87 patients with gastric adenomas and 174 sex-age-matched controls among 19,019 subjects who underwent esophagogastroduodenoscopy and colonoscopy simultaneously or within 6 months from January 2001 to December 2008 at the Center for Health Promotion of Samsung Medical Center. Results: There were 72 men and 15 women with gastric adenoma. Colorectal adenomas were identified in 42 (48.3%) of 87 cases and in 58 (33.3%) of 174 controls (p=0.022). The prevalence of colorectal adenoma was significantly higher in gastric adenoma group than in control group. The mean size and the number of colorectal adenomas were not significantly different between the two groups. The majority of colorectal adenoma was located in distal colonic segments in gastric adenoma group in contrast with proximal colonic segments in control group. According to the multivariate logistic regression analysis, independent risk factors of colorectal adenoma were increasing age over 55 years (odds ratio (OR)=2.107; 95% confidence interval (CI), 1.219-3.641) and the presence of gastric adenomas (OR=1.913; 95% CI, 1.101-3.325). Conclusion: The risk of colorectal adenoma increased significantly in patients with gastric adenomas and those over the age of 55. Our results suggest that screening colonoscopy may be necessary for patients with gastric adenomas to find colorectal adenomas. Am J Gastroenterol 2009; 104:S168-S190; doi:10.1038/ajg.2009.492