caa a22 4500 44579660X CHVBK 20180317145127.0 cr unu---uuuuu 170323e20110801xx s 000 0 eng 10.1007/s10620-011-1606-1 doi (NATIONALLICENCE)springer-10.1007/s10620-011-1606-1 Should a Colonoscopy be Recommended for Healthy Individuals with Increased Carcinoembryonic Antigen Levels? A Case-Control Study [Elektronische Daten] [Jin Lee, Sung Hong, Tae Jeon, Gun-Hi Kang, Won-Choong Choi, Soung Jeon, Chang Moon, Jae Park, Jae Cheon, Tae Kim, Won Kim] Background and Aim: Despite the limitations of screening or early diagnosis of colorectal cancers (CRC), carcinoembryonic antigen (CEA) is frequently measured in practice and during health promotion programs. The aim of this study was to evaluate the role of colonoscopy in healthy individuals with elevated CEA levels. Methods: From January 2003 to November 2008, 117,731 healthy persons underwent an opportunistic screening program in two health promotion centers; 1,497 subjects (1.3%) showed an elevated CEA level (>5ng/ml). Among them, 174 patients were recruited to undergo a colonoscopy to determine if colorectal malignancies were present. A total of 372 age- and sex-matched persons were selected as controls from among the healthy subjects who had a normal level of CEA and had received surveillance colonoscopy. The primary outcome was the incidences of CRC in elevated CEA and normal CEA groups. The secondary outcome was the predictive factors of CRC in the elevated CEA group. Results: The incidence of CRC was higher in the group with higher CEA-levels than in the group with normal CEA levels (4.6 vs. 1.3%; P=0.031). In the CEA-elevated group, patients with CRCs were diagnosed at more advanced stages than were those in the CEA-normal group. The incidence of colorectal polyps was not different between the two groups. In the CEA-elevated group, anemia was an independent predictive factor of CRCs by multivariate analysis (P=0.002). Conclusion: Anemia itself is not a predictive factor of CRC in the entire population, but is an independent predictive factor of CRC in healthy individuals with an elevated level of CEA. Therefore, colonoscopy should be recommended for healthy subjects with an elevated level of CEA accompanied with anemia in the absence of other adenocarcinomas to evaluate the presence of colorectal malignancy. Springer Science+Business Media, LLC, 2011 Carcinoembryonic antigen nationallicence Colonoscopy nationallicence Colorectal cancer nationallicence Lee Jin Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, 120-752, Seoul, Republic of Korea aut Hong Sung Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, 120-752, Seoul, Republic of Korea aut Jeon Tae Department of Internal Medicine and Division of Gastroenterology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea aut Kang Gun-Hi Department of Internal Medicine and Division of Gastroenterology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea aut Choi Won-Choong Department of Internal Medicine and Division of Gastroenterology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea aut Jeon Soung Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, 120-752, Seoul, Republic of Korea aut Moon Chang Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, 120-752, Seoul, Republic of Korea aut Park Jae Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, 120-752, Seoul, Republic of Korea aut Cheon Jae Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, 120-752, Seoul, Republic of Korea aut Kim Tae Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, 120-752, Seoul, Republic of Korea aut Kim Won Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, 120-752, Seoul, Republic of Korea aut Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/8(2011-08-01), 2396-2403 0163-2116 56:8<2396 2011 56 10620 https://doi.org/10.1007/s10620-011-1606-1 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10620-011-1606-1 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Lee Jin Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, 120-752, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Hong Sung Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, 120-752, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Jeon Tae Department of Internal Medicine and Division of Gastroenterology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Kang Gun-Hi Department of Internal Medicine and Division of Gastroenterology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Choi Won-Choong Department of Internal Medicine and Division of Gastroenterology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Jeon Soung Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, 120-752, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Moon Chang Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, 120-752, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Park Jae Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, 120-752, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Cheon Jae Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, 120-752, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Kim Tae Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, 120-752, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Kim Won Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, 120-752, Seoul, Republic of Korea aut NATIONALLICENCE 773 0- Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/8(2011-08-01), 2396-2403 0163-2116 56:8<2396 2011 56 10620 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer