RESUMEN
BACKGROUND/AIMS: Previous studies regarding the risk for colorectal neoplasms in women with a prior diagnosis of gynecological cancer have revealed conflicting results. Therefore, we conducted a cross-sectional study to quantify the risk for colorectal neoplasms in patients with gynecological cancers. METHODOLOGY: A total of 4613 women (including 27, 51 and 92 women with a prior diagnosis of endometrial, ovarian and cervical cancers, respectively) >20 years of age were recruited prospectively from 9 tertiary medical centers in Korea between January 2008 and February 2009. All participants underwent complete colonoscopies for vague abdominal signs or symptoms or for colorectal cancer screening. Several risk factors for colorectal neoplasms and a prior history of gynecological cancer were compared between women with and without colorectal neoplasms. RESULTS: The risk for colorectal neoplasms was only elevated among women with previous endometrial cancer, but with ovarian or cervical cancer, particularly when diagnosed at <50 years of age (adjusted OR=3.7; 95% CI=1.0-13.3, p=0.016). CONCLUSIONS: This study demonstrated a higher risk for colorectal neoplasms in women with previous endometrial cancer, particularly when diagnosed at <50 years of age. Greater emphasis on colorectal cancer screening in this population may be necessary.
Asunto(s)
Colonoscopía , Neoplasias Colorrectales/epidemiología , Tamizaje Masivo/métodos , Neoplasias Primarias Secundarias/epidemiología , Neoplasias Ováricas/epidemiología , Neoplasias del Cuello Uterino/epidemiología , Adulto , Factores de Edad , Anciano , Neoplasias Colorrectales/diagnóstico , Estudios Transversales , Femenino , Humanos , Modelos Logísticos , Persona de Mediana Edad , Análisis Multivariante , Neoplasias Primarias Secundarias/diagnóstico , Oportunidad Relativa , Selección de Paciente , Valor Predictivo de las Pruebas , Estudios Prospectivos , República de Corea/epidemiología , Medición de Riesgo , Factores de RiesgoRESUMEN
BACKGROUND/AIMS: Many prognostic models have been developed to help physicians make medical decisions on treating patients with pulmonary embolism. Among these models, the Pulmonary Embolism Severity Index (PESI) has been shown to be a successful risk stratification tool for patients with acute pulmonary embolism. The PESI, however, had not been applied to patients with pulmonary embolism in Korea. METHODS: The patients included in this study were diagnosed by computed tomography at Inje University's Ilsan Paik Hospital between December 1999 and March 2007. Risk stratification for the patients was performed using the PESI. The mortality rate was calculated according to each PESI risk class. RESULTS: Of the 90 patients enrolled in this study, ten were assigned to PESI class I, 29 to PESI class II, 22 to PESI class III, eight to PESI class IV, and ten to PESI class V. The mortality rate after 30 days in each class was 0, 10.3, 9.1, 0, and 50% (p=0.0016), respectively, whereas the respective hospital mortality rate was 4.8, 13.8, 13.6, 12.5, and 50% (p=0.0065). The overall mortality was 9.5, 27.6, 31.8, 50.0, and 60%, respectively (p=0.0019). The mortality rate was significantly associated with the PESI class. CONCLUSIONS: The PESI class was found to be significantly correlated with the 30-day mortality rate, hospital mortality, and overall mortality. Our data indicate that the PESI can be used to predict the prognosis of patients with pulmonary embolism and in making medical decisions regarding the treatment of patients with pulmonary embolism.
