Annals of Coloproctology

Review

Benign bowel disease

Colorectal screening following appendectomy in adult patients: a systematic review: Francesco Esposito, Marco Del Prete, Matilde Magri, Fanny Dufour, Alexandre Cortes; Ann Coloproctol. 2024;40(5):417-423. Published online August 1, 2024; DOI: https://doi.org/10.3393/ac.2023.00528.0075

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Abstract PDF: Purpose
Although the association between appendicitis and colorectal cancer in older patients has received attention, postoperative colorectal screening through endoscopy is not currently recommended. This study conducted a systematic review of the literature on colorectal screening following appendectomy in adult patients.
Methods
A literature search was performed using online databases. Studies reporting colorectal surveillance after appendectomy in adult patients were retrieved for assessment.
Results
Eight articles including a total of 3,995 patients were published between 2013 and 2023. An age of 40 years was the lower threshold in 6 of the 8 articles. Postoperative colorectal screening occurred in 771 patients (19.3%). Endoscopy was performed in 95.2% of cases and computed tomography–colonography in 4.8%. During endoscopic examinations, a lesion was discovered in 184 of 771 patients (24.0%), and an adenomatous polyp was found in 154 of 686 patients (22.5%). The overall cancer rate was 3.9% (30 of 771 patients). The tumor was located in the right-sided colon in 46.7% of the patients, in the cecum in 20.0%, in the rectum in 16.7%, in the left-sided colon in 10.0%, and in the sigmoid colon in 6.7%.
Conclusion
Performing post-appendectomy colorectal screening in patients >40 years of age could allow early detection of an underlying lesion.

Original Articles

Colorectal cancer

Public effect of the 2022 Colorectal Cancer Awareness Campaign delivered through a metaverse platform: Tae-Gyun Lee, Gil-Hyeon Song, Hong-min Ahn, Heung-Kwon Oh, Moonkyoung Byun, Eon Chul Han, Sohyun Kim, Chang Woo Kim, Hye Jin Kim, Samin Hong, Kee-Ho Song, Chan Wook Kim, Yong Beom Cho, on behalf of the Public Relations Committee of the Korean Society of Coloproctology (KSCP); Ann Coloproctol. 2024;40(2):145-153. Published online April 28, 2023; DOI: https://doi.org/10.3393/ac.2023.00122.0017

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Graphical Abstract Abstract PDF

Purpose
The Korean Society of Coloproctology has been conducting Colorectal Cancer Awareness Campaign, also known as the Gold Ribbon Campaign, every September since 2007. The 2022 campaign was held through a metaverse platform targeting the younger age group under the slogan of raising awareness of early-onset colorectal cancer (CRC). This study aimed to analyze the impact of the 2022 campaign on a metaverse platform.
Methods
Anonymized survey data were collected from participants in the metaverse campaign from September 1 to 15, 2022. The satisfaction score of the participants was evaluated by sex, age group, and previous campaign participation status.
Results
During the campaign, 2,770 people visited the metaverse. Among them, 455 people participated in the survey (response rate, 16.4%). Approximately 95% of the participants reported being satisfied with the information provided by the campaign, understood the necessity of undergoing screening for and prevention of early-onset CRC, and were familiar with the structure of the metaverse. The satisfaction score for campaign information tended to decrease as the participants’ age increased. When the participants’ overall level of satisfaction with the metaverse platform was assessed, teenagers scored particularly lower than the other age groups. The satisfaction scores for CRC information provided in the metaverse, as well as the scores for recognizing the seriousness and necessity of screening for early-onset CRC, indicated a high positive tendency (P<0.001).
Conclusion
Most of the 2022 Gold Ribbon Campaign participants were satisfied with the metaverse platform. Medical society should pay attention to increasing participation in and satisfaction with future public campaigns.

Citations

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Toward Diagnosis of Diseases Using Emerging Technologies: A Comprehensive Survey of the State of the Art in Metaverse
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Malignant disease,Colorectal cancer,Epidemiology & etiology

Clinicopathologic characteristics of early-onset colorectal cancer: Kui Seon Park, Young Ki Hong, Yoon Jung Choi, Jung Gu Kang; Ann Coloproctol. 2022;38(5):362-369. Published online March 11, 2022; DOI: https://doi.org/10.3393/ac.2021.00976.0139

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Abstract PDF

Purpose
The aim of this study was to analysis of the clinicopathological characteristics and prognosis of colorectal cancer (CRC) under the age of 50 years.
Methods
Between January 2009 and December 2018, 1,126 primary CRC patients were included from National Health Insurance Service Ilsan Hospital. The patients were divided into group 1 (n=111, ≤50 years) and group 2 (n=1,015, >50 years). The clinicopathologic features and prognostic outcomes were compared. In addition, to analyze whether there were any differences of those characteristics in 3 groups, patients aged under 50 years were divided into their 20s, 30s, and 40s.
Results
Group 1 had a slightly higher distribution in the left colon and rectum, lower T stage I and higher T stage IV rate, and a significantly higher distribution in stage N2 than group 2 (30.6%:16.3%, P<0.001). Poor histological differentiation of tumors was significantly high in group 1 (P=0.003). The 5-year survival rate for those in their 30s (69.2%) and 40s (91.6%) was higher than those in their 20s who died immediately after surgery (P<0.001). The 5-year disease-free survival rate was also confirmed to be meaningful for each age group, with 0% in their 20s, 53.8% in their 30s, 79.2% in their 40s (P<0.001).
Conclusion
Although the age was not an independent prognostic factor for overall survival in this study, the early onset group of CRCs is more advanced at the time of diagnosis and has a more aggressive histologic type.

Citations

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Surgical Techniques for Transanal Local Excision for Early Rectal Cancer
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Review

Malignant disease, Rectal cancer

Current Colorectal Cancer in Thailand: Varut Lohsiriwat, Nopdanai Chaisomboon, Jirawat Pattana-Arun, for the Society of Colorectal Surgeons of Thailand; Ann Coloproctol. 2020;36(2):78-82. Published online January 31, 2020; DOI: https://doi.org/10.3393/ac.2020.01.07

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19 Web of Science
17 Citations

Abstract PDF

This article aimed to summarize the current status of colorectal cancer (CRC) in Thailand. In brief, CRC is the third most common cancer and accounts for 11% of the cancer burden in Thailand. It is the only malignancy with an increased incidence in both sexes in Thailand. Over 10,000 new CRC cases occur annually, and about 40% are rectal cancer. Due to the lack of CRC screening and public awareness, nonmetastatic cancer accounts only for 60%–70% of overall cases. The demand for general or colorectal surgeons outmatches the supply at a ratio of 1 general surgeon to 35,000 individuals. There are about 70 board-certified colorectal surgeons serving Thailand’s population of nearly 70 million. As a result, >25% of cancer patients wait more than 1 month before surgery. Regarding training for colorectal surgery, there are 3 major institutes in Bangkok providing a 2-year fellowship program. Cadaveric workshops are an important part of training – especially in laparoscopy for CRC. Recently, a population-based CRC screening program was launched using a fecal immunochemical test. The Ministry of Public Health of Thailand has established additional platforms for laparoscopy to support the potential detection of early CRC following implementation of this nationwide screening program.

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Stent as a bridge to surgery for malignant colonic obstruction: a retrospective study on survival and outcomes
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New oxepin and dihydrobenzofuran derivatives from Bauhinia saccocalyx roots and their anti-inflammatory, cytotoxic, and antioxidant activities
Lueacha Tabtimmai, Thanyathon Phonchan, Natrinee Thongprik, Sutin Kaennakam, Nuttapon Yodsin, Kiattawee Choowongkomon, Chanikan Sonklin, Supachai Jadsadajerm, Awat Wisetsai
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Relationship between the protein expression of ARID1A, ARID1B and ARID2 with the clinicopathological characteristics of colorectal cancer
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Original Articles

Clinical Features of Colorectal Cancer Detected by the National Cancer Screening Program: Dae-Do Park, Rumi Shin, Ji-Sun Kim, Heung-Kwon Oh, Seung-Yong Jeong, Kyu Joo Park, Jae-Gahb Park; J Korean Soc Coloproctol. 2010;26(6):420-423. Published online December 31, 2010; DOI: https://doi.org/10.3393/jksc.2010.26.6.420

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4 Citations

Abstract PDF

Purpose

Since 2004, the National Cancer Screening Program of Korea has included colorectal cancer screening based on primary screening with the fecal occult blood test (FOBT). We report on the clinical features of colorectal cancer detected by the National Cancer Screening Program.

Methods

We retrospectively analyzed 577 patients who underwent elective surgery for colorectal cancer at the Seoul National University Hospital between January 2008 and December 2009. We compared the clinical features of colorectal cancers detected by the National Cancer Screening Program (NCSP group) with those of the control group in terms of age, gender, preoperative symptom, location of the tumor, surgical technique and tumor-node-metastasis (TNM) stage.

Results

Age, gender, location of the tumor and operation types were not different between the two groups. The proportion of asymptomatic patients was significantly higher in the NCSP group than it was in the control group (86.5% vs. 20.0%; P < 0.001). The proportion of less invasive lesions (T1 or T2) was significantly higher in the NCSP group (46.3% vs. 27.7%; P = 0.002). The pathologic stages of the colorectal cancers in the NCSP group were I, 40.3%; II, 17.9%; III, 40.3% and IV, 1.5% whereas in the control group, they were I, 20.8%; II, 32.9%; III, 34.9% and IV, 11.4%. The proportion of stage I cancer was significantly higher in the NCSP group than in the control group (40.3% vs. 20.8%; P = 0.006).

Conclusion

Our study demonstrates the FOBT in the NCSP is effective in early detection of colorectal cancer.

Citations

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Clinicopathological Characteristics of Colorectal Adenomas and Cancers Detected by FIT-positive Colonoscopy
Seiji Kimura, Shinichiro Yamagishi, Shinsaku Fukuda
Nippon Daicho Komonbyo Gakkai Zasshi.2020; 74(1): 6. CrossRef
Predictive Nomogram for Recurrence of Stage I Colorectal Cancer After Curative Resection
Chan Kim, Woo Ram Kim, Ki-Yeol Kim, Hong Jae Chon, Seung Hoon Beom, Hyojoong Kim, Minkyu Jung, Sang Joon Shin, Nam Kyu Kim, Joong Bae Ahn
Clinical Colorectal Cancer.2018; 17(3): e513. CrossRef
Early Colorectal Epithelial Neoplasm in Korea: A Multicenter Survey of Pathologic Diagnosis
Yun Kyung Kang, So-Young Jin, Mee Soo Chang, Jung Yeon Kim, Gyeong Hoon Kang, Hye Seung Lee, Jin Hee Sohn, Ho Sung Park, Kye Won Kwon, Mi Jin Gu, Young Hee Maeng, Jong Eun Joo, Haeng Ji Kang, Hee Kyung Kim, Kee-Taek Jang, Mi Ja Lee, Hee Kyung Chang, Joon
Korean Journal of Pathology.2013; 47(3): 245. CrossRef
Clinicopathologic Factors Affecting Recurrence after Curative Surgery for Stage I Colorectal Cancer
Min Ae Keum, Seok-Byung Lim, Sun A Kim, Yong Sik Yoon, Chan Wook Kim, Chang Sik Yu, Jin Cheon Kim
Journal of the Korean Society of Coloproctology.2012; 28(1): 49. CrossRef

Characteristics of Colorectal Cancer Detected at the Health Promotion Center.: Yoon, Yong Sik , Yu, Chang Sik , Jung, Sang Hoon , Choi, Pyong Wha , Han, Kyong Rok , Kim, Hee Cheol , Kim, Jin Cheon; J Korean Soc Coloproctol. 2007;23(5):321-326.; DOI: https://doi.org/10.3393/jksc.2007.23.5.321

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3 Citations

Abstract PDF

PURPOSE
Colorectal cancer is regarded as preventable with routine checkups. The purpose of this study was to evaluate the usefulness of each test performed during routine checkups and to assess the clinicopathological characteristics of colorectal cancer detected at the Health Promotion Center (HPC).
RESULTS
We recruited 120 colorectal cancer patients identified on routine checkup at the HPC. The control group was composed of 3,829 colorectal cancer patients who underwent surgery during the same period. Clinicopathological variables were compared using the chi-square test.
RESULTS
The male-to-female ratio was 79:41; the mean age was 57.9 (30~78) years. The incidence of right colon cancer was 16.7%, and that of left colon cancer was 83.7%. Sigmoidoscopy (55.5%), colonoscopy (28.3%), and fecal occult blood tests (FOBT, 10.8%) were used for detecting colorectal cancer. The overall positive rates of FOBT and serum carcinoembryonic antigen (CEA) were 28.3% and 20.8%, respectively, but were higher in advanced colon cancer (49.0% and 31.4%) and right colon cancer (60% and 25%). Early colorectal cancer was more frequent in the study group (54.9%) than in the control group (16.9%, P<0.001). Right colon cancer was significantly associated with advanced colon cancer (80%), and left colon cancer was associated with early colon cancer (62.3%, P=0.001).
CONCLUSIONS
Endoscopy, including sigmoidoscopy and colonoscopy, played a crucial role in detecting early colorectal cancer at the HPC. Including endoscopy in basic routine checkup programs should help to increase early detection of colorectal cancer.

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Polymeric chitosan-glycolipid nanocarriers for an effective delivery of marine carotenoid fucoxanthin for induction of apoptosis in human colon cancer cells (Caco-2 cells)
Hindupur Ravi, Nawneet Kurrey, Yuki Manabe, Tatsuya Sugawara, Vallikannan Baskaran
Materials Science and Engineering: C.2018; 91: 785. CrossRef
Features of Late Recurrence Following Transanal Local Excision for Early Rectal Cancer
Bo Young Oh, Hae-Ran Yun, Seok Hyung Kim, Seong Hyeon Yun, Hee Cheol Kim, Woo Yong Lee, Ho-Kyung Chun, Yong Beom Cho
Diseases of the Colon & Rectum.2015; 58(11): 1041. CrossRef
The green algae Ulva fasciata Delile extract induces apoptotic cell death in human colon cancer cells
Min Ju Ryu, Areum Daseul Kim, Kyoung Ah Kang, Ha Sook Chung, Hye Sun Kim, In Soo Suh, Weon Young Chang, Jin Won Hyun
In Vitro Cellular & Developmental Biology - Animal.2013; 49(1): 74. CrossRef

Treatment Patterns for Colorectal Cancer Patients at the National Cancer Center Korea in 2003.: Kim, Duck Woo , Jeong, Seung Yong , Kim, Dae Yong , Sohn, Dae Kyung , Lim, Seok Byung , Chang, Hee Jin , Jung, Kyung Hae , Jeong, Jun Yong , Choi, Hyo Seong , Park, Jae Gahb; J Korean Soc Coloproctol. 2007;23(4):245-249.; DOI: https://doi.org/10.3393/jksc.2007.23.4.245

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2 Citations

Abstract PDF

PURPOSE
In Korea, colorectal cancer (CRC) is one of the most sharply-increasing malignancies, and the National Colorectal Cancer Screening Program for persons over 50 years of age began in 2004. To determine the effectiveness of the program, comparative data regarding CRCs treated prior to 2004 must be analyzed. The present study assessed CRC status at diagnosis and treatment patterns in 2003.
METHODS
In 2003, 503 patients were newly diagnosed with CRC and were treated at the Center for Colorectal Cancer, National Cancer Center (NCC). Clinical data were retrospectively reviewed.
RESULTS
The 503 patients included 256 colon and 247 rectal cancer patients. Of the 256 colon cancer patients, 5 (2.0%) were diagnosed during screening colonoscopies and were successfully treated using an endoscopic mucosal resection (EMR), and 17 (6.6%) received only palliative chemotherapy because of distant metastases. Forty patients (15.6%) were treated with palliative surgery and chemotherapy, and 194 (75.8%) with curative surgery with or without adjuvant chemotherapy. Of the 247 rectal cancer patients, 9 (3.6%) were treated with an EMR, 20 (8.1%) with palliative chemotherapy with or without radiotherapy, 19 (7.7%) with palliative surgery and chemoradiotherapy, and 199 (80.6%) with curative surgery with or without chemoradiotherapy. Treatment with curative intent was possible in 199 of 256 (77.7%) colon cancer patients and in 208 of 247 (84.2%) rectal cancer patients.
CONCLUSIONS
Only 12.1% of colon and 8.5% of rectal cancer patients were diagnosed early and treated without adjuvant therapies at the NCC in Korea in 2003.

Citations

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Lymphovascular Invasion is a Significant Prognosticator in Rectal Cancer Patients Who Receive Preoperative Chemoradiotherapy Followed by Total Mesorectal Excision
Jong Hoon Lee, Hong Seok Jang, Jun-Gi Kim, Hyun Min Cho, Byoung Yong Shim, Seong Taek Oh, Sei-Chul Yoon, Yeon-Sil Kim, Byung Ock Choi, Sung Hwan Kim
Annals of Surgical Oncology.2012; 19(4): 1213. CrossRef
Role of Radiation Therapy as an Adjuvant Treatment in Rectal Cancer Management
Jae Hwan Oh, Dae Yong Kim
Journal of the Korean Society of Coloproctology.2009; 25(4): 273. CrossRef

Distribution and Characteristics of Colorectal Polyps at Colonoscopy.: Lee, Jeong Eun , Yoon, Se Jin , Ahn, Eun Jung , Chung, Soon Sup , Lee, Ryung Ah , Kim, Kwang Ho , Park, Eung Bum; J Korean Soc Coloproctol. 2006;22(4):223-228.

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Abstract PDF: PURPOSE
The screening test for colorectal polyp is important for the early detection and prevention of colorectal cancer. The aims of this study were to evaluate the characteristic findings and the anatomical distribution of colorectal polyps observed during colonoscopy and to determine proper screening candidates to undergo colonoscopy for colorectal cancer.
METHODS
From March 1999 to February 2004, 3,454 asymptomatic individuals underwent total colonoscopy. The number, the location, and the histology of polyps were evaluated retrospectively in 634 patients who had colorectal polyps (453 males and 181 females). The relations among age, location, and histology were analyzed.
RESULTS
The mean age was 60 years (range, 15 to 95). Four hundred and twenty-two patients (67%) had a single polyp, and 212 (33%) had two or more polyps. Left-sided polyps were observed in 422 patients (67%), right-sided polyps in 134 patients (21%), and synchronous both-sided polyps in 78 patients (12%). Adenomas were present in 387 patients (61%), and adenocarcinomas were detected in 47 patients (7.4%). There was no definite correlation between location and histology. However the prevalence of right-sided polyps increased with age (P<0.01).
CONCLUSIONS
More than 30% of the polyps were located proximal to the splenic flexure. Thus, in the absence of left-sided lesions, an examination of the colon that is limited to the splenic flexure might miss 21% of such lesions. The increasing prevalence of right-sided polyps with age suggests that evaluation of the proximal colon is particularly important in the elderly, especially in those older than 60 years.

Is Routine Chest X-ray Useful in Detection of Pulmonary Metastases after Curative Resection for Colorectal Carcinoma?.: Yun, Seong Hyeon , Park, Sung Bae , Kang, Sin Jae , Park, Chi Min , Jeong, Keuk Won , Chang, Weon Young , Lee, Woo Yong , Chun, Ho Kyung; J Korean Soc Coloproctol. 2004;20(3):169-175.

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Abstract PDF: PURPOSE
This study was performed to evaluate the effectiveness of conventional chest radiography and abdominal CT for early detection of pulmonary metastases after curative surgery for colorectal cancer.
METHODS
We retrospectively reviewed 138 cases of pulmonary metastases from a group of colorectal-cancer patients, who were recruited from 1994 to 2002 at Samsung Medical Center, Sungkyunkwan University School of Medicine, and who had been surgically treated with a curative resection.
RESULTS
The detection rates for pulmonary metastases were 34.1% by conventional chest radiography, 50.0% by abdominal CT, and 15.9% by other means. For stage I and II tumors, conventional chest radiography was superior to abdominal CT (45.7% vs. 34.3%, P<0.05) for detecting pulmonary metastases. On the contrary, for stage III tumors, abdominal CT was superior to conventional chest radiography (55.3% vs. 30.1%, P<0.05). Compared with stage I and II, pulmonary metastases in stage III had a tendency to be more numerous, bilateral, and extra-pulmonary. They also had a low detection rate by conventional chest radiography and a higher detection rate by abdominal CT, and they were associated with poor survival.
CONCLUSIONS
Conventional chest radiography is no more useful in detecting early pulmonary metastases after curative colorectal surgery than abdominal CT, especially for stage III tumors. We propose the use of routine chest CT or extended abdominal CT for screening of occult lung metastases in stage III colorectal cancer patients.

Availability of Flexible Sigmoidoscopy for Outpatients, Inpatients,and Mass Screening at a Proctologic Clinic.: Yoo, Jung Joon , Kim, Hyun Shig , Park, Weon Kap , Hwang, Do Yean , Kim, Kuhn Uk , Lee, Kwang Real , Lim, Seok Won , Lee, Jong Kyun; J Korean Soc Coloproctol. 1999;15(4):291-300.

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Abstract PDF: PURPOSE
The clinical guidelines and rationale published by the American Gastroenterological Association in 1997 recommended that it is not necessary to screen patients in the average risk group who are below the age of 50. The purpose of this study was to evaluate both the effectiveness of flexible sigmoidoscopy (FS) as a diagnostic and screening tool and the utility of screening at an age earlier than 50 years.
METHODS
From Jan. to Dec. 1997, FS was used in 8964 cases. These cases were divided into three groups: Group A, 1336 outpatients; Group B, 5308 cases involving a hemorrhoidal operation; and Group C, 2320 cases of mass screening.
RESULTS
The mean age was lower in Group B (42.4 11.5) than in Group A (47.0 14.5) and Group C (46.1 10.7). The incidences of cancer, inflammatory bowel disease (IBD), and nonspecific proctocolitis in Group A were significantly higher than they were in Groups B and C, and the FS findings in Groups B and C were similiar. The locations of the polyps, cancer, IBD, and nonspecific proctocolitis were below the left colon in 91.9% cases involving an abnormal finding. Also, the locations of polyps and IBD determined by using FS and by using colonoscopy (CS) were not very different. About two-thirds of the carcinomas found by using FS in all three groups were located in the upper rectum and the sigmoid. In Group B, the FS findings did not depend on whether or not an enema had been administered. Also, the total incidence of cancer in patients less than forty years of age was nearly the same as the incidence of cancer in Group B and the incidence of cancer in Group C.
CONCLUSIONS
The risk of cancer for patients in the average risk group who are under 50 years of age should not be underestimated. FS is effective not only for the diagnosis of colorectal disease but also as an initial screening technique for patients below forty years of age.

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