Clinical impact of colonoscopy for patients with early gastric cancer treated by endoscopic submucosal dissection: A matched case-control study.

BACKGROUND: Gastric cancer frequently occurs synchronously with colorectal cancer (CRC).

AIMS: The aim of the present study was to assess the value of colonoscopy in patients with primariy early gastric cancer (EGC) indicated for endoscopic submucosal dissection (ESD) and to identify predictors for the risk of high-risk adenomas.

METHODS: A total of 130 patients with EGC, who underwent both colonoscopy and gastric ESD, and 260 controls matched for age and sex, who underwent a colonoscopy as part of our institutional health check-up program. The prevalence of high-risk adenomas in EGC patients vs. controls was evaluated.

RESULTS: High-risk adenomas were found in 43 (33%) EGC patients and 37 (14%) controls (P<0.01). Multivariate analysis showed the presence of EGC was significantly associated with high-risk adenoma [odds ratio (OR) 2.8, 95% confidence interval (CI): 1.7-4.9]. Among EGC patients, high serum CEA level (OR 2.4, 95% CI: 1.2-5.0) was an independent predictor for high-risk adenoma.

CONCLUSIONS: Patients with EGC had a significant risk for colorectal cancer. When endoscopists detected an early gastric cancer indicated for ESD, colonoscopy should be considered for EGC patients with high serum CEA levels.