risk of advanced colorectal neoplasia according to age and gender先进的结直肠肿瘤的风险根据年龄和性别.pdfVIP

Risk of Advanced Colorectal Neoplasia According to Age and Gender 1 2 3 1 2 Frank T. Kolligs *, Alexander Crispin , Axel Munte , Andreas Wagner , Ulrich Mansmann , Burkhard ¨ 1 Goke 1 Department of Medicine II, University of Munich, Munich, Germany, 2 Institute of Medical Informatics, Biometry, and Epidemiology, University of Munich, Munich, Germany, 3 Bavarian Association of Compulsory Health Insurance Physicians, Munich, Germany Abstract Background: Colorectal cancer (CRC) is one of the leading causes of cancer related morbidity and death. Despite the fact that the mean age at diagnosis of CRC is lower in men, screening by colonoscopy or fecal occult blood test (FOBT) is initiated at same age in both genders. The prevalence of the common CRC precursor lesion, advanced adenoma, is well documented only in the screening population. The purpose of this study was to assess the risk of advanced adenoma at ages below screening age. Methods and Findings: We analyzed data from a census of 625,918 outpatient colonoscopies performed in adults in Bavaria between 2006 and 2008. A logistic regression model to determine gender- and age-specific risk of advanced neoplasia was developed. Advanced neoplasia was found in 16,740 women (4.6%) and 22,684 men (8.6%). Male sex was associated with an overall increased risk of advanced neoplasia (odds ratio 1.95; 95% confidence interval, CI, 1.91 to 2.00). At any age and in any indication group, more colonoscopies were needed in women than in men to detect advanced adenoma or cancer. At age 75 14.8 (95% CI, 14.4–15.2) screening, 18.2 (95% CI, 17.7–18.7) diagnostic, and 7.9 (95% CI, 7.6–8.2) colonoscopies to follow up on a positive FOBT (FOBT colonoscopies) were needed to find