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Original Articles
- A Case-control Study of the Relationships between Reproductive Factors and Degree of Dysplasia of the Colorectal Adenoma and Cancer.
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Se Young Lee, Won Chul Lee, Kyu Yong Choi, Mi Kyung Kim, Jin Hee Lee, Kwang Ho Meng
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Korean J Prev Med. 2003;36(3):279-288.
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Abstract
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- OBJECTIVES
Evidence for an effect of reproductive factors on colorectal carcinogenesis is not yet consistent. Little research has been conducted to investigate whether reproductive factors were associated with colorectal adenomas that are the precursors of colorectal cancer. We evaluated the relationships between reproductive factors and the degree of dysplasia of the colorectal adenoma and cancer as colorectal adenoma-carcinoma sequence. METHODS: For this study, 241 adenoma cases with histo-pathologically confirmed incident colorectal adenoma, 76 cancer cases with colorectal cancer and 1677 controls were collected from Our Lady of Mercy Hospital, The Catholic University of Korea, during 1994-1999. Before colonoscopy, information on demographic characteristics, reproductive factors, life style habits and dietary intake were obtained by interviewed questionnaire. Adjusted OR and 95% CI were estimated by using polytomous logistic regression model. Potential confounders that were selected based on the goodness of fit statistics and interaction between risk factors were considered in this adjustment. The Wald statistic was calculated to test the heterogeneity of the odds ratios for each case. RESULTS: Postmenopausal women with natural menopause were found to be positively associated with the risk of mild dysplasia adenoma (multivariate-adjusted OR : 2.59, 95% CI=1.1-6.2). Parity was found to be negatively associated with the risk of colorectal cancer (age-adjusted OR : 0.40, 95% CI=0.2-0.9), but did not significantly decrease the risk of colorectal cancer (multivariate-adjusted OR : 0.95, 95% CI=0.3-2.9). No associations were seen between age at menarche, breast feeding, induced abortion, oral contraceptive use, menopausal types, menopausal age or hormone replacement therapy (HRT) and the degree of dysplasia of the colorectal adenoma and cancer. However, none of these associations differed significantly between the degree of dysplasia of the colorectal adenoma and cancer. CONCLUSIONS: These findings suggest that postmenopausal women with natural menopause may experience increased risk of mild dysplasia adenoma among colorectal adenoma-carcinoma sequence.
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Summary
- Serum Pepsinogen Levels as a Screening Test of Gastric Cancer and Adenoma in Korea.
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Jang Rak Kim, Jin Hak Choi, Young Chai Kim, Ok Jae Lee, Kyu Il Cho, Han Woo Lee, Dae Yong Hong
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Korean J Prev Med. 1994;27(4):677-692.
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Abstract
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- To evaluate the validity of serum pepsinogen levels as a screening tool for gastric cancer and adenoma, immunoradiometric assays of serum pepsinogen I level (PG I), II level (PG II) and esphagogastroduodenal endoscopies were done in 757 health examlnees. Serum PG I level was higher in subjects with active duodenal ulcer (n=45, 75.2+/-34.3 microgram/l(mean+/-standard deviation), p<0.01) and gastroduodenal ulcers (n=8,756+/-19.8 microgram/l, p<0.05), and was lower in those with gastric adenoma (n=4,37.7+/-37.2 microgram/l, p<0.2) than those with normal, mild gastritis findings or ulcer scars (n=378, 56.6+/-24.9 microgram/l). Serum PG II level las higher in subjects with active duodenal ulcer (17.2+/-13.8 microgram/l, p<0.2), active gastro-duodenal ulcers (l8.3+/-7.4 microgram/l, p<0.2) and gastric carcinoma (n=3, 23.8+/-10.9 microgram/l, p<0.05) than those with normal, mild gastritis findings or ulcer scars (14.5+/-7.9 microgram/l). Serum PG I/PG 11 ratio was higher in subjects with active duodenal ulcer (5.1+/-1.6, p<0.05) and was lower in those with chronic gastritis (n=107, 4.1+/-1.7, p<0.05), gastric polyp (n=19, 3.9+/-1.4, p<0.2), gastric adenoma (n=4, 2.1+/-1.9, p<0.01) and gastric carcinoma (n=3, 2.7+/-1.2, p<0.1) than those with normal, mild gastritis findings or ulcer scars (4.5+/-1.7). Serum PG 11 level increased with age until 6th decade, whereas serum PG I/PG II ratio decreased with age in 378 subjects with normal, mild gastritis findings or ulcer scars. The screening criteria of serum PG I<70 microgram/l and PG I/PG II ratio<3.0 for detecting gastric cancer and adenorna gave a positive rate of 15.7%, sensitivity of 57.1% and specificity of 84.7%.
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Summary
English Abstract
- The Association of Obesity and Left Colonic Adenomatous Polyps in Korean Adult Men.
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Chang Sup Kim, Moon Chan Kim, Hae Kwan Cheong, Tae Heum Jeong
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J Prev Med Public Health. 2005;38(4):415-419.
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Abstract
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- OBJECTIVES
We wanted to evaluate the relationship between obesity and left colonic adenomatous polyps in Korean adult men. METHODS: This study was conducted among 575 adults men (aged between 40 and 69), who had colonoscopy done from January to December 2002 during a routine health examination at Health Promotion Center, Ulsan University Hospital. The patients' colons were examined up to splenic flexure by using fiberoptic colonoscopy. A questionnaire survey on behavioral factors and physical measurements were also done. The body mass index (BMI) and waist-hip ratio (WHR) were used as the indices of obesity. The BMI was categorized into three levels: normal (BMI < or =22.9), overweight (23< or =BMI< or =24.9), and obese (BMI> or =25.0). The WHR was categorized into four levels with cutoff points at the 30th, 60th, and 90th percentile of the control group. Age, education, smoking, alcohol use and exercise were controlled for by performing multiple logistic regression analysis. RESULTS: There were 99 cases of colonic adenomatous polyps. Four hundred seventy six subjects with normal colonoscopy findings served as the control. The BMI and WHR were associated with the adenomatous polyps (odds ratio, 1.81 [95% CI=1.02-3.19] for a BMI> or =25.0 as compared with a BMI< or =22.9, odds ratio, 3.94 [95% CI=1.77- 8.77] for a WHR > or =0.95 as compared with a WHR< or =0.86). The BMI was not associated with the risk of adenomatous polyps after additional adjustment was made for the WHR, but the association between the WHR and adenomatous polyps was still positive and independent of the BMI (odds ratio, 4.15 [95% CI=1.63-10.59]). CONCLUSIONS: The results support that obesity, and particularly abdominal obesity, can be associated with an increased risk of incurring colonic adenomatous polyps.
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Summary
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