Japanese Journal of Clinical Oncology Advance Access published online on August 23, 2007
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hym065
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© 2007 Foundation for Promotion of Cancer Research
Colorectal Polypectomy and Risk of Colorectal Cancer by Subsite: The Fukuoka Colorectal Cancer Study
1 Department of Preventive Medicine
2 Department of Surgery and Oncology
3 Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka
4 Department of Gastroenterological Surgery, National Kyushu Cancer Center, Fukuoka
5 Division of Surgery, National Kyushu Medical Center, Fukuoka
6 Department of Surgery, Fukuoka University Chikushi Hospital, Chikushino, Fukuoka
7 The First Department of Surgery, Fukuoka University School of Medicine, Fukuoka
8 The Second Department of Surgery, Fukuoka University School of Medicine, Fukuoka
9 Division of Surgery, Fukuoka City Hospital, Fukuoka
10 Division of Surgery, Hamanomachi General Hospital, Fukuoka
11 Division of Surgery, Fukuoka Red Cross Hospital, Fukuoka, Japan
For reprints and all correspondence: Daigo Yoshida, Department of Preventive Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. E-mail: dyoshida{at}phealth.med.kyushu-u.ac.jp
Received December 24, 2006; accepted March 15, 2007
Background: Colorectal adenomas are well-established precursor lesions for colorectal cancer and removal of polyps is deemed to reduce the risk of colorectal cancer. However, benefit of colorectal polypectomy in routine practice is still uncertain. We therefore investigated subsite-specific risks of colorectal cancer in relation to history of colorectal polypectomy in a case-control study.
Methods: Both case patients and control subjects were residents aged 20–74 years in Fukuoka City and three adjacent areas. The case group comprised 840 patients undergoing surgery for a first diagnosis of colorectal cancer, while the control subjects were 833 residents who were selected in the community by two-stage random sampling. Past history of selected diseases, surgery and lifestyle factors were ascertained by in-person interview. Statistical adjustment was made for sex, 5-year age class, residence, smoking, alcohol drinking, physical activity, body mass index and parental history of colorectal cancer.
Results: Overall, 74 case patients (9%) and 85 control subjects (10%) reported a prior history of colorectal polyps, and 50 cases (6%) and 64 controls (8%) had a history of colorectal polypectomy. The adjusted odds ratio associated with colorectal polypectomy was 0.71 (95% confidence interval [CI] 0.48–1.06) for the overall risk of colorectal cancer. The corresponding values for cancer of the proximal colon, distal colon, and rectum were 1.68 (95% CI 0.98–2.88), 0.71 (95% CI 0.41–1.26) and 0.24 (95% CI 0.11–0.52), respectively.
Conclusions: The findings indicate that colorectal polypectomy in current practice confers a decreased risk of rectal cancer and possibly of distal colon cancer.
Key Words: colorectal cancer • colorectal polypectomy • case-control study • Japanese