Is Preoperative Work-Up Colonoscopy Necessary for Patient with Gastric Cancer?

ABSTRACT

BACKGROUND/AIMS: Recently, many studies have reported the incidence of colorectal neoplasm (CRN) to be increased in patients with gastric cancer. Thus preoperative colonoscopy is recommended for the screening of CRN. The purpose of this study is to investigate the prevalence of colorectal adenoma and cancer in patients with gastric cancer and evaluate the necessity of preoperative colonoscopy in patients with gastric cancer. MATERIALS AND METHODS: We collected data from 293 patients who underwent gastrectomy due to gastric cancer at one tertiary institution between January to December 2015. Preoperative colonoscopy was performed in 127 patients of 293 patients. To compare the prevalence of colorectal neoplasm, we selected 900 persons who underwent upper esophagogastroduodenoscopy and colonoscopy for health screening during 2015. RESULTS: The prevalence of overall CRN was similar in the gastric cancer group and the control group. The prevalence of colorectal advanced adenoma and cancer was higher in the gastric cancer group compared with control group, but it did not show statistical significance. The prevalence of colorectal advanced adenoma was significantly higher in the group of age ≥ years and smoking. CONCLUSIONS: The risk of advanced colorectal adenoma increases significantly in patients with old age but not in patients with gastric cancer. We suggest that all patients with gastric cancer might not carry a high risk for advanced colorectal adenoma compared with the normal population. Patients with old age might require surveillance colonoscopy.