Impact of Metabolic Syndrome on Prevalence of Colorectal Neoplasm and Possible Implication on Screening Strategy
Date Issued
2012
Date
2012
Author(s)
Chang, Li-Chun
Abstract
Background
Gender and metabolic disorders have proven to play an important role on the risk of colorectal neoplasm. Whether the presence of metabolic syndrome (MetS) may warrant earlier screening is intriguing and its impact on endoscopic capacity is worthwhile of investigation.
Methods
We analyzed a screening colonoscopy cohort comprised of 10,884 average-risk subjects who had concurrently received screening colonoscopy and fecal immunochemical testing as a part of thorough health check-up from the period of 2006 to 2009. Results of anthropometric measurements, blood pressure, and laboratory tests including fasting blood sugar, triglyceride, and cholesterol levels were all collected. Prevalence of colorectal neoplasm were assessed and compared in association with age, gender, and the presence of metabolic syndrome. The number of colonoscopy that needed to be performed with either endoscopy-based or stool-based screening strategies to detect one advanced neoplasm was calculated and compared.
Results
Subjects with MetS had significantly higher prevalence of colorectal neoplasms and positive predictive values of stool tests in both genders across different age groups in those aged 50 or greater. Such trend is only significant in male aged 40 to 49 but not in female. The prevalence of advanced adenoma in MetS male aged 40 to 49 was comparable to that of average-risk female aged 50 to 59 (2.4% vs. 2.0%, p=0.709). The number need to endoscope (NNE) to detect one advanced adenoma in MetS male aged 40 to 49 and average-risk female aged 50-59 were 44 and 47 in with endoscopic-based screening scenario and 7 and 8 with stool-based screening scenario.
Conclusions
MetS has more significant impact on both colorectal neoplasm prevalence and the diagnostic yields of screening tests in male aged 40 to 49. Whether our findings justify earlier screening in this subgroup needs further study.
Subjects
Metabolic syndrome
colon cancer
colonoscopy
fecal occult blood test
colon cancer screening
SDGs
Type
thesis
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