Retrospective Cohort Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Jan 15, 2024; 16(1): 51-60
Published online Jan 15, 2024. doi: 10.4251/wjgo.v16.i1.51
Trends in colorectal cancer incidence according to an increase in the number of colonoscopy cases in Korea
Ga Hee Kim, Yeong Chan Lee, Tae Jun Kim, Sung Noh Hong, Dong Kyung Chang, Young-Ho Kim, Dong-Hoon Yang, Chang Mo Moon, Kyunga Kim, Hyun Gun Kim, Eun-Ran Kim
Ga Hee Kim, Dong-Hoon Yang, Division of Gastroenterology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea
Yeong Chan Lee, Department of Digital Health, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea
Tae Jun Kim, Sung Noh Hong, Dong Kyung Chang, Young-Ho Kim, Eun-Ran Kim, Division of Gastroenterology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea
Chang Mo Moon, Division of Gastroenterology, Department of Internal Medicine, Ewha Womans University, Seoul 07985, South Korea
Kyunga Kim, Biomedical Statistics Center, Samsung Medical Center, Seoul 06351, South Korea
Hyun Gun Kim, Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul 04401, South Korea
Co-first authors: Ga Hee Kim and Yeong Chan Lee.
Author contributions: Kim TJ, Hong SN, Chang DK, Kim YH, Yang DH, Moon CM, Kim K, Kim HG, and Kim ER performed critical revision of the manuscript for important intellectual content; Kim GH and Lee YC acquired data from the National Health Insurance Service claims database and analyzed the data; Kim GH And Lee YC interpreted the data; Kim GH and Lee YC participated in the design of the study and performed the statistical analysis; the results shown in tables and figures were performed by Kim GH and Lee YC. The main text of the manuscript was written by Kim GH and Lee YC. Kim GH and Lee YC reviewed and edited the manuscript. Kim GH and Lee YC contributed equally to this work as co-first authors of this paper. Kim ER and Kim HG contributed the study concept and design. All authors have read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved for publication by our Institutional Reviewer.
Informed consent statement: In this retrospective cohort study, patients were not required to give informed consent to the study as the analysis used the National Health Insurance Service claims database which contains anonymous clinical data and is deidentified with regard to gender, age, and medical history.
Conflict-of-interest statement: All the Authors have no conflict of interest related to the manuscript.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Eun-Ran Kim, MD, PhD, Professor, Staff Physician, Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, No. 81 Irwon-ro, Seoul 06351, South Korea. er.kim@samsung.com
Received: September 6, 2023
Peer-review started: September 6, 2023
First decision: October 16, 2023
Revised: October 26, 2023
Accepted: November 8, 2023
Article in press: November 8, 2023
Published online: January 15, 2024
Processing time: 126 Days and 18.2 Hours
Abstract
BACKGROUND

The incidence of colorectal cancer (CRC) and preinvasive CRC (e.g., early colon cancer and advanced adenoma) is gradually increasing in several countries.

AIM

To evaluate the trend in incidence of CRC and preinvasive CRC according to the increase in the number of colonoscopies performed in Korea.

METHODS

This retrospective cohort study enrolled Korean patients from 2002 to 2020 to evaluate the incidence of CRC and preinvasive CRC, and assess the numbers of diagnostic colonoscopies and colonoscopic polypectomies. Colonoscopy-related complications by age group were also determined.

RESULTS

The incidence of CRC showed a rapid increase, then decreased after 2012 in the 50-75 year-age group. During the study period, the rate of incidence of preinvasive CRC increased at a similar level in patients under 50 and 50-75 years of age. Since 2009, the increase has been rapid, showing a pattern similar to the increase in colonoscopies. The rate of colonoscopic polypectomy in patients aged under 50 was similar to the rate in patients over 75 years of age after 2007. The rate of complications after colonoscopy and related deaths within 3 mo was high for those over 75 years of age.

CONCLUSION

The diagnosis of preinvasive CRC increased with the increase in the number of colonoscopies performed. As the risk of colonoscopy-related hospitalization and death is high in the elderly, if early lesions at risk of developing CRC are diagnosed and treated under or at the age of 75, colonoscopy-related complications can be reduced for those aged 76 years or over.

Keywords: Colorectal cancer; Preinvasive colorectal cancer; Colorectal polypectomy; Colonoscopy

Core Tip: In Korea, colorectal cancer (CRC) showed the second highest incidence rate among all cancers in 2018. The volume of colonoscopies and colorectal polypectomies in Korea is also increasing due to the CRC screening program initiated in 2004, and rapid population aging. The purpose of this study was to evaluate the trend in incidence of CRC and preinvasive CRC according to the increase in the number of colonoscopies performed in Korea.