Older Age Is Associated with a Higher Incidence Colonic Adenomas During Colonoscopy
Notice bibliographique
Résumé
Purpose: Our nations life expectancy is growing. It is projected to increase from 76.0 years in 1993 to 82.6 years in 2050. Older age is also shown to be associated with increased risk of multiple cancers including colorectal cancer (CRC). The purpose of our study is to report the association of older age with polyp and adenoma detection during colonoscopy. Methods: We prospectively enrolled 430 patients undergoing outpatient colonoscopies from March to July 2011. We collected data using medical records and questionnaires participants completed before colonoscopy. Polyp detection rate (PDR) was calculated from colonoscopy reports, and adenoma detection rate (ADR) was calculated from pathology reports. Age was categorized in three groups: <55 years of age, 55-65 years of age, and >65 years of age. Pearson's Chisquare or Kendall's tau-b tests were used to identify factors associated with detection of polyps and adenomas. Multiple multivariate analyses were performed to determine independent predictors for polyp and adenoma detection. Results: The mean age was 60.4 (24-84) including 30.9% >55 years of age, 39.3% 55-65 years of age, and 29.8% >65 years of age. 211 (49.1%) participants were male. 223 (48.1%) were screening colonoscopies (no prior colonoscopy, the last colonoscopy ≥ 10 years, or no symptoms). 87.3% of the bowel preparations were excellent or good (total Ottawa score 4 or less). 35.5% of all adenomas were in the right colon (cecum and ascending colon). The overall PDR was 57.4% and the ADR was 44%. In a univariate analysis, age was significantly associated with PDR and ARD in the whole colon as well as the right colon for all patients (p≤0.001 for all). After adjusting for gender, BMI, race, history of colonoscopy, quality of bowel prep (Ottawa score), and comorbidities (diabetes, stroke), age remained independently associated with polyp and adenoma detection in the entire colon (p=0.001 for both). In subgroup analysis, age>65 was associated with a much higher PDR and ADR than age 55-65 while compared with age< 65 years (p=0.003 and p<0.001 vs. 0.949 and p=0.304 respectively). Conclusion: Older age is strongly associated with a higher PDR and ADR after adjusting for gender, BMI and quality of bowel preparation. Our finding correlates strongly with the known risk of increase colorectal cancer in older patients. Age >65 years is also associated with a much higher risk of adenoma than age 55-65 years in all our patients. This may have implications in stratifying the highest risk population for CRC especially in areas where resources are limited.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».