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E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
Patients with Gastric Polyps need Colonoscopy Screening at Younger Age: A Large Prospective Cross-Sectional Study in
Shenghong Zhang1, Danping Zheng1, Zhiwei Yang2
1Division of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, P.R. China.
Insights
Patients with gastric polyps have a significantly higher risk of developing colorectal adenomas, including advanced types. This suggests that colonoscopy screening may be beneficial for individuals with gastric polyps, particularly those over 40.
Area of Science:
- Gastroenterology
- Oncology
- Preventive Medicine
Background:
- The necessity of colonoscopy screening for asymptomatic patients with gastric polyps remains unclear.
- Gastric polyps may indicate an increased risk for colorectal neoplasia.
Purpose of the Study:
- To prospectively investigate the association between the presence of gastric polyps and the prevalence of colorectal neoplasia.
Main Methods:
- A multicenter prospective cross-sectional study involving 1546 patients (770 with gastric polyps, 776 controls).
- Comparison of colorectal adenoma prevalence between patients with and without gastric polyps.
- Logistic regression analysis with multivariable adjustments to calculate odds ratios (OR).
Main Results:
- Patients with gastric polyps showed significantly higher odds of having any colorectal adenoma (aOR=2.34) and advanced colorectal adenomas (aOR=2.71).
- This association was consistent across genders and in patients over 40, with increasing prevalence in older age groups.
- The positive association between gastric polyps and colorectal adenomas remained statistically significant in all analyzed subgroups.
Conclusions:
- Gastric polyp presence is strongly linked to a higher prevalence of colorectal adenomas, particularly advanced adenomas.
- Consideration of colonoscopy screening for patients diagnosed with gastric polyps, irrespective of gender and over 40 years of age, is warranted.
Abstract:
Background To date, it is not clarified whether patients with gastric polyps without any alarming symptoms for colorectal neoplasia need colonoscopy screening. The objective of this study is to prospectively determine the association between gastric polyps and colorectal neoplasia. Methods A multicenter prospective cross-sectional study was performed from July 2012 to December 2014. We compared patients with and without gastric polyps for prevalence of colorectal adenomas. The odds ratios (OR) were computed by logistic regression analysis after multivariable adjustments. Results Totally 1546 patients were included, with 770 patients in the gastric polyp group and 776 in the age- and sex- matched control group. Patients with gastric polyps had greater odds of having any colorectal adenoma (adjusted OR=2.34, 95% confidence interval [CI]: 1.79 to 3.06, p<0.001) and advanced colorectal adenomas (adjusted OR=2.71, 95% CI: 1.74 to 4.23, p<0.001) than those without. The positive association between gastric polyps and colorectal adenomas remained significant in both women (OR=2.34, 95% CI: 1.66 to 3.29, p<0.001) and men (OR=1.87, 95% CI: 1.31 to 2.66, p=0.001). Patients over the age of 40 with gastric polyps had a higher prevalence of colorectal adenomas than those without (40-49yr: OR=1.81, 95% CI=1.02-3.21, p=0.04; 50-59yr: OR=1.88, 95% CI=1.26-2.81, p<0.001; 60-74yr: OR=2.62, 95% CI=1.73-3.98, p<0.001). Conclusions The presence of gastric polyps is significantly associated with a higher prevalence of colorectal adenomas, especially advanced colorectal adenomas. Colonoscopy might be considered in patients with gastric polyps, of any gender, and over the age of 40.
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