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Background and Aim: Although obesity is a known risk factor for colorectal neoplasms, the correlation between weight change and colorectal neoplasm is unclear. Thus, we aim to evaluate the association between weight change and advanced colorectal neoplasm (ACRN) recurrence during post‐polypectomy surveillance colonoscopy. Methods: This retrospective cohort study included 7473 participants diagnosed with colorectal neoplasms between 2003 and 2010 who subsequently underwent surveillance colonoscopies until 2020. We analyzed the association between the risk of metachronous ACRN and weight change, defining stable weight as a weight change of <3% and weight gain as a weight increase of ≥3% from baseline during the follow‐up period. Results: During a median 8.5 years of follow‐up, 619 participants (8.3%) developed ACRN. Weight gain was reported as an independent risk factor for metachronous ACRN in a time‐dependent Cox analysis. A weight gain of 3–6% and ≥6% had adjusted hazard ratios (AHRs) of 1.48 (95% confidence interval [CI]: 1.19–1.84) and 2.14 (95% CI: 1.71–2.69), respectively. Participants aged 30–49 and 50–75 years with weight gain of ≥6% showed AHRs of 2.88 (95% CI: 1.96–4.21) and 1.90 (95% CI: 1.43–2.51), respectively. In men and women, weight gain of ≥3% was significantly correlated with metachronous ACRN. Conclusions: Weight gain is associated with an increased risk of metachronous ACRN. Furthermore, weight gain is associated with the recurrence of ACRN in both men and women regardless of age. [ABSTRACT FROM AUTHOR]

Background and Aim: The clinical significance of incidental pancreatic cystic lesions (PCLs) remains unclear in those that are not accompanied by worrisome features or high‐risk stigmata. We aimed to investigate the natural course of PCLs without any risk features and examine the clinical factors associated with their progression. Methods: We conducted a retrospective cohort study of 427 patients with PCLs, which were incidentally detected by computed tomography between January 2003 and December 2012. Progression of PCLs without any risk features and the clinical factors associated with their progression were investigated. The length of time to significant growth was also evaluated. Results: Ninety‐four (22.0%) of the 427 patients had asymptomatic PCLs that showed significant growth after a median surveillance period of 5.3 years; approximately 27.7% of the patients showed significant size changes in the first 5 years, while the remaining 72.3% showed significant changes after 5 years. The cumulative rate of patients with significant growth was associated with initial cyst size and high body mass index. In the growth group, additional treatments were required for 12 patients, one of whom developed malignancy. Four patients in the stable group underwent additional treatment and showed no malignant change. Conclusions: One‐fifth of the asymptomatic PCLs significantly increased in size after a long‐term follow‐up period, which was associated with initial cyst size and obesity. The size of PCLs mostly increased after 5 years; although the malignancy risk of PCLs was low, it was still a concern. [ABSTRACT FROM AUTHOR]

Background and Aim Current guidelines recommend colon cancer screening for persons aged over 50 years. However, there are few data on colorectal cancer screening in 40- to 49-year-olds. This study assessed the prevalence and risk factors of colorectal neoplasms in 40- to 49-year-old Koreans. Methods We analyzed the results of screening colonoscopies of 6680 persons 40-59 years of age (2206 aged 40-49 and 4474 aged 50-59 years). Results The prevalence of overall and advanced neoplasms in the 40- to 49-year age group was lower than in the 50- to 59-year age group (26.7% and 2.4% vs 37.8% and 3.5%, respectively). However, the prevalence of overall and advanced neoplasms increased to 39.1% and 5.4%, respectively, in 45- to 49-year-old individuals with metabolic syndrome. In the 40- to 49-year age group, age, current smoking, and metabolic syndrome were associated with an increased risk of advanced neoplasms (odds ratio [OR] 1.16, 95% confidence interval [CI] 1.04-1.30; OR 3.12, 95% CI 1.20-8.12; and OR 2.00, 95% CI 1.09-3.67, respectively). Conclusions Individuals aged 40-49 years had a lower prevalence of colorectal neoplasms than those aged 50-59 years, but some 40- to 49-year-olds showed a similar prevalence to those aged 50-59 years. Age, current smoking habits, and metabolic syndrome are associated with an increased risk of advanced neoplasms in subjects aged 40-49 years. Further studies are needed to stratify the risks of colon cancer and guide targeted screening in persons younger than 50 years old. [ABSTRACT FROM AUTHOR]

Background and Aim: Although metabolic factors such as obesity and hyperlipidemia were reported to be associated with high prevalence of colorectal neoplasm (CRN), their influence on the occurrence of CRN at surveillance colonoscopy has not been clarified. The purpose of this study was to analyze the association between metabolic factors and the risk of CRN at the time of surveillance colonoscopy. Methods: We reviewed the medical records of 1792 asymptomatic subjects (average 52.1 years, 1233 male) who underwent screening and follow-up surveillance colonoscopies. Fasting glucose level, fasting insulin level, hemoglobin A1c (HbA1c), lipid profile, high sensitivity C-reactive protein, and colonoscopic findings at the time of baseline screening were analyzed to find any associations with the occurrence of CRN at the time of surveillance colonoscopy. Results: The median interval between screening and surveillance colonoscopies was 3.34 years. The 3- and 5-year cumulative CRN incidences were 22.3% and 54.8%, respectively. Several metabolic factors such as hypertension, waist circumference, fasting insulin, fasting glucose, HbA1c, and triglyceride were associated with the occurrence of CRN in univariate analysis. Age, current alcohol drinker status, and high-risk colonoscopy findings at baseline remained independent risk factors for CRN occurrence in multivariate analysis. High waist circumference was also an independent risk factor (hazard ratio 1.03, 95% CI 1.02-1.04; P < 0.001). Conclusions: Metabolic factors, especially waist circumference, affect CRN occurrence at the time of surveillance colonoscopy. The surveillance colonoscopy interval may be optimized based on metabolic factors and screening colonoscopy findings. [ABSTRACT FROM AUTHOR]

Background and Aim: The relationship between age and esophageal motility parameters (i.e. basal and residual pressure of the lower esophageal sphincter [LES]) remains to be established in achalasia patients, possibly because most previous studies did not distinguish between classic and vigorous achalasia patients. We investigated the relationship between age and esophageal motility parameters in both classic and vigorous achalasia patients. Methods: A retrospective review of esophageal manometry data in a single center was undertaken. Basal and residual pressure for LES was analyzed. A total of 103 achalasia patients were enrolled, comprising 84 classic and 19 vigorous types. They were subdivided into three different age groups as follows: 21-40 years old (group A), 41-60 years old (group B), and over 60 years old (group C). Results: In classic achalasia patients (M : F = 27:57, mean age = 44 ± 15 years old) the older age group showed a significantly higher basal LES pressure (49.62 ± 19.63 mmHg) than the younger age group ( P < 0.0001). Moreover, the older age group also showed significantly high residual LES pressure (20.46 ± 8.61 mmHg) than the younger age group ( P = 0.0006). In contrast, in vigorous achalasia patients (M : F = 12:7, mean age: 47 ± 15 years old) there were no difference between age and motility indices (all P > 0.05). Conclusion: In classic achalasia patients there appears to be a correlation between age and esophageal motility indices, especially basal and residual LES pressure. Such correlations do not appear to exist for vigorous achalasia patients. [ABSTRACT FROM AUTHOR]