High prevalence of colorectal neoplasm in patients with non-alcoholic steatohepatitis
ObjectiveNon-alcoholic fatty liver disease (NAFLD) affects 20–40% of the general adult population. Due to shared risk factors, it is postulated that NAFLD patients have an increased risk of colorectal neoplasm and should be a target group for screening. The aim of this study was to examine the preva...
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| Published in | Gut Vol. 60; no. 6; pp. 829 - 836 |
|---|---|
| Main Authors | , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
London
BMJ Publishing Group Ltd and British Society of Gastroenterology
01.06.2011
BMJ Publishing Group BMJ Publishing Group LTD |
| Subjects | |
| Online Access | Get full text |
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| Abstract | ObjectiveNon-alcoholic fatty liver disease (NAFLD) affects 20–40% of the general adult population. Due to shared risk factors, it is postulated that NAFLD patients have an increased risk of colorectal neoplasm and should be a target group for screening. The aim of this study was to examine the prevalence of colorectal neoplasm in NAFLD patients and the risk of colorectal neoplasm in relation to the severity of NAFLD histology.DesignCross-sectional study.SettingUniversity hospital with case recruitment from the community and clinics.PatientsSubjects aged 40–70 years were recruited for colonoscopic screening from two study cohorts: (1) community subjects; and (2) consecutive patients with biopsy proven NAFLD. In the community cohort, hepatic fat was measured by proton-magnetic resonance spectroscopy.Main outcome measuresPrevalence of colorectal adenomas. Advanced colorectal neoplasm was defined as cancer or adenomas with villous architecture or high grade dysplasia.ResultsNAFLD patients (N=199) had a higher prevalence of colorectal adenomas (34.7% vs 21.5%; p=0.043) and advanced neoplasms (18.6% vs 5.5%; p=0.002) than healthy controls (N=181). Thirteen of 29 (45%) NAFLD patients with advanced neoplasms had isolated lesions in the right sided colon. Among patients with biopsy proven NAFLD, patients with non-alcoholic steatohepatitis (N=49) had a higher prevalence of adenomas (51.0% vs 25.6%; p=0.005) and advanced neoplasms (34.7% vs 14.0%; p=0.011) than those with simple steatosis (N=86). After adjusting for demographic and metabolic factors, non-alcoholic steatohepatitis remained associated with adenomas (adjusted OR 4.89, 95% CI 2.04 to 11.70) and advanced neoplasms (OR 5.34, 95% CI 1.92 to 14.84). In contrast, the prevalence of adenomas and advanced neoplasms was similar between patients with simple steatosis and control subjects.ConclusionsNon-alcoholic steatohepatitis is associated with a high prevalence of colorectal adenomas and advanced neoplasms. The adenomas are found more commonly in the right sided colon. Colorectal cancer screening is strongly indicated in this high risk group. |
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| AbstractList | ObjectiveNon-alcoholic fatty liver disease (NAFLD) affects 20–40% of the general adult population. Due to shared risk factors, it is postulated that NAFLD patients have an increased risk of colorectal neoplasm and should be a target group for screening. The aim of this study was to examine the prevalence of colorectal neoplasm in NAFLD patients and the risk of colorectal neoplasm in relation to the severity of NAFLD histology.DesignCross-sectional study.SettingUniversity hospital with case recruitment from the community and clinics.PatientsSubjects aged 40–70 years were recruited for colonoscopic screening from two study cohorts: (1) community subjects; and (2) consecutive patients with biopsy proven NAFLD. In the community cohort, hepatic fat was measured by proton-magnetic resonance spectroscopy.Main outcome measuresPrevalence of colorectal adenomas. Advanced colorectal neoplasm was defined as cancer or adenomas with villous architecture or high grade dysplasia.ResultsNAFLD patients (N=199) had a higher prevalence of colorectal adenomas (34.7% vs 21.5%; p=0.043) and advanced neoplasms (18.6% vs 5.5%; p=0.002) than healthy controls (N=181). Thirteen of 29 (45%) NAFLD patients with advanced neoplasms had isolated lesions in the right sided colon. Among patients with biopsy proven NAFLD, patients with non-alcoholic steatohepatitis (N=49) had a higher prevalence of adenomas (51.0% vs 25.6%; p=0.005) and advanced neoplasms (34.7% vs 14.0%; p=0.011) than those with simple steatosis (N=86). After adjusting for demographic and metabolic factors, non-alcoholic steatohepatitis remained associated with adenomas (adjusted OR 4.89, 95% CI 2.04 to 11.70) and advanced neoplasms (OR 5.34, 95% CI 1.92 to 14.84). In contrast, the prevalence of adenomas and advanced neoplasms was similar between patients with simple steatosis and control subjects.ConclusionsNon-alcoholic steatohepatitis is associated with a high prevalence of colorectal adenomas and advanced neoplasms. The adenomas are found more commonly in the right sided colon. Colorectal cancer screening is strongly indicated in this high risk group. Non-alcoholic fatty liver disease (NAFLD) affects 20-40% of the general adult population. Due to shared risk factors, it is postulated that NAFLD patients have an increased risk of colorectal neoplasm and should be a target group for screening. The aim of this study was to examine the prevalence of colorectal neoplasm in NAFLD patients and the risk of colorectal neoplasm in relation to the severity of NAFLD histology. Design Cross-sectional study. University hospital with case recruitment from the community and clinics. Subjects aged 40-70 years were recruited for colonoscopic screening from two study cohorts: (1) community subjects; and (2) consecutive patients with biopsy proven NAFLD. In the community cohort, hepatic fat was measured by proton-magnetic resonance spectroscopy. Prevalence of colorectal adenomas. Advanced colorectal neoplasm was defined as cancer or adenomas with villous architecture or high grade dysplasia. NAFLD patients (N=199) had a higher prevalence of colorectal adenomas (34.7% vs 21.5%; p=0.043) and advanced neoplasms (18.6% vs 5.5%; p=0.002) than healthy controls (N=181). Thirteen of 29 (45%) NAFLD patients with advanced neoplasms had isolated lesions in the right sided colon. Among patients with biopsy proven NAFLD, patients with non-alcoholic steatohepatitis (N=49) had a higher prevalence of adenomas (51.0% vs 25.6%; p=0.005) and advanced neoplasms (34.7% vs 14.0%; p=0.011) than those with simple steatosis (N=86). After adjusting for demographic and metabolic factors, non-alcoholic steatohepatitis remained associated with adenomas (adjusted OR 4.89, 95% CI 2.04 to 11.70) and advanced neoplasms (OR 5.34, 95% CI 1.92 to 14.84). In contrast, the prevalence of adenomas and advanced neoplasms was similar between patients with simple steatosis and control subjects. Non-alcoholic steatohepatitis is associated with a high prevalence of colorectal adenomas and advanced neoplasms. The adenomas are found more commonly in the right sided colon. Colorectal cancer screening is strongly indicated in this high risk group. Non-alcoholic fatty liver disease (NAFLD) affects 20-40% of the general adult population. Due to shared risk factors, it is postulated that NAFLD patients have an increased risk of colorectal neoplasm and should be a target group for screening. The aim of this study was to examine the prevalence of colorectal neoplasm in NAFLD patients and the risk of colorectal neoplasm in relation to the severity of NAFLD histology. Design Cross-sectional study.OBJECTIVENon-alcoholic fatty liver disease (NAFLD) affects 20-40% of the general adult population. Due to shared risk factors, it is postulated that NAFLD patients have an increased risk of colorectal neoplasm and should be a target group for screening. The aim of this study was to examine the prevalence of colorectal neoplasm in NAFLD patients and the risk of colorectal neoplasm in relation to the severity of NAFLD histology. Design Cross-sectional study.University hospital with case recruitment from the community and clinics.SETTINGUniversity hospital with case recruitment from the community and clinics.Subjects aged 40-70 years were recruited for colonoscopic screening from two study cohorts: (1) community subjects; and (2) consecutive patients with biopsy proven NAFLD. In the community cohort, hepatic fat was measured by proton-magnetic resonance spectroscopy.PATIENTSSubjects aged 40-70 years were recruited for colonoscopic screening from two study cohorts: (1) community subjects; and (2) consecutive patients with biopsy proven NAFLD. In the community cohort, hepatic fat was measured by proton-magnetic resonance spectroscopy.Prevalence of colorectal adenomas. Advanced colorectal neoplasm was defined as cancer or adenomas with villous architecture or high grade dysplasia.MAIN OUTCOME MEASURESPrevalence of colorectal adenomas. Advanced colorectal neoplasm was defined as cancer or adenomas with villous architecture or high grade dysplasia.NAFLD patients (N=199) had a higher prevalence of colorectal adenomas (34.7% vs 21.5%; p=0.043) and advanced neoplasms (18.6% vs 5.5%; p=0.002) than healthy controls (N=181). Thirteen of 29 (45%) NAFLD patients with advanced neoplasms had isolated lesions in the right sided colon. Among patients with biopsy proven NAFLD, patients with non-alcoholic steatohepatitis (N=49) had a higher prevalence of adenomas (51.0% vs 25.6%; p=0.005) and advanced neoplasms (34.7% vs 14.0%; p=0.011) than those with simple steatosis (N=86). After adjusting for demographic and metabolic factors, non-alcoholic steatohepatitis remained associated with adenomas (adjusted OR 4.89, 95% CI 2.04 to 11.70) and advanced neoplasms (OR 5.34, 95% CI 1.92 to 14.84). In contrast, the prevalence of adenomas and advanced neoplasms was similar between patients with simple steatosis and control subjects.RESULTSNAFLD patients (N=199) had a higher prevalence of colorectal adenomas (34.7% vs 21.5%; p=0.043) and advanced neoplasms (18.6% vs 5.5%; p=0.002) than healthy controls (N=181). Thirteen of 29 (45%) NAFLD patients with advanced neoplasms had isolated lesions in the right sided colon. Among patients with biopsy proven NAFLD, patients with non-alcoholic steatohepatitis (N=49) had a higher prevalence of adenomas (51.0% vs 25.6%; p=0.005) and advanced neoplasms (34.7% vs 14.0%; p=0.011) than those with simple steatosis (N=86). After adjusting for demographic and metabolic factors, non-alcoholic steatohepatitis remained associated with adenomas (adjusted OR 4.89, 95% CI 2.04 to 11.70) and advanced neoplasms (OR 5.34, 95% CI 1.92 to 14.84). In contrast, the prevalence of adenomas and advanced neoplasms was similar between patients with simple steatosis and control subjects.Non-alcoholic steatohepatitis is associated with a high prevalence of colorectal adenomas and advanced neoplasms. The adenomas are found more commonly in the right sided colon. Colorectal cancer screening is strongly indicated in this high risk group.CONCLUSIONSNon-alcoholic steatohepatitis is associated with a high prevalence of colorectal adenomas and advanced neoplasms. The adenomas are found more commonly in the right sided colon. Colorectal cancer screening is strongly indicated in this high risk group. OBJECTIVE: Non-alcoholic fatty liver disease (NAFLD) affects 20-40% of the general adult population. Due to shared risk factors, it is postulated that NAFLD patients have an increased risk of colorectal neoplasm and should be a target group for screening. The aim of this study was to examine the prevalence of colorectal neoplasm in NAFLD patients and the risk of colorectal neoplasm in relation to the severity of NAFLD histology. DESIGN: Cross-sectional study. SETTING: University hospital with case recruitment from the community and clinics. PATIENTS: Subjects aged 40-70 years were recruited for colonoscopic screening from two study cohorts: (1) community subjects; and (2) consecutive patients with biopsy proven NAFLD. In the community cohort, hepatic fat was measured by proton-magnetic resonance spectroscopy. MAIN OUTCOME MEASURES: Prevalence of colorectal adenomas. Advanced colorectal neoplasm was defined as cancer or adenomas with villous architecture or high grade dysplasia. RESULTS: NAFLD patients (N=199) had a higher prevalence of colorectal adenomas (34.7% vs 21.5%; p=0.043) and advanced neoplasms (18.6% vs 5.5%; p=0.002) than healthy controls (N=181). Thirteen of 29 (45%) NAFLD patients with advanced neoplasms had isolated lesions in the right sided colon. Among patients with biopsy proven NAFLD, patients with non-alcoholic steatohepatitis (N=49) had a higher prevalence of adenomas (51.0% vs 25.6%; p=0.005) and advanced neoplasms (34.7% vs 14.0%; p=0.011) than those with simple steatosis (N=86). After adjusting for demographic and metabolic factors, non-alcoholic steatohepatitis remained associated with adenomas (adjusted OR 4.89, 95% CI 2.04 to 11.70) and advanced neoplasms (OR 5.34, 95% CI 1.92 to 14.84). In contrast, the prevalence of adenomas and advanced neoplasms was similar between patients with simple steatosis and control subjects. CONCLUSIONS: Non-alcoholic steatohepatitis is associated with a high prevalence of colorectal adenomas and advanced neoplasms. The adenomas are found more commonly in the right sided colon. Colorectal cancer screening is strongly indicated in this high risk group. |
| Author | Woo, Jean Wong, Vincent Wai-Sun Chan, Francis Ka-Leung Sung, Joseph Jao-Yiu Wong, Grace Lai-Hung Chan, Anthony Wing-Hung Choi, Paul Cheung-Lung Tsang, Steven Woon-Choy Chan, Henry Lik-Yuen Chu, Winnie Chiu-Wing Fan, Tina Chim, Angel Mei-Ling Lau, James Yun-Wong |
| Author_xml | – sequence: 1 givenname: Vincent Wai-Sun surname: Wong fullname: Wong, Vincent Wai-Sun organization: Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China – sequence: 2 givenname: Grace Lai-Hung surname: Wong fullname: Wong, Grace Lai-Hung organization: Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China – sequence: 3 givenname: Steven Woon-Choy surname: Tsang fullname: Tsang, Steven Woon-Choy organization: Department of Medicine, Tseung Kwan O Hospital, Hong Kong, China – sequence: 4 givenname: Tina surname: Fan fullname: Fan, Tina organization: Department of Medicine, Tseung Kwan O Hospital, Hong Kong, China – sequence: 5 givenname: Winnie Chiu-Wing surname: Chu fullname: Chu, Winnie Chiu-Wing organization: Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China – sequence: 6 givenname: Jean surname: Woo fullname: Woo, Jean organization: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China – sequence: 7 givenname: Anthony Wing-Hung surname: Chan fullname: Chan, Anthony Wing-Hung organization: Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Hong Kong, China – sequence: 8 givenname: Paul Cheung-Lung surname: Choi fullname: Choi, Paul Cheung-Lung organization: Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Hong Kong, China – sequence: 9 givenname: Angel Mei-Ling surname: Chim fullname: Chim, Angel Mei-Ling organization: Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China – sequence: 10 givenname: James Yun-Wong surname: Lau fullname: Lau, James Yun-Wong organization: Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China – sequence: 11 givenname: Francis Ka-Leung surname: Chan fullname: Chan, Francis Ka-Leung organization: Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China – sequence: 12 givenname: Joseph Jao-Yiu surname: Sung fullname: Sung, Joseph Jao-Yiu organization: Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China – sequence: 13 givenname: Henry Lik-Yuen surname: Chan fullname: Chan, Henry Lik-Yuen email: hlychan@cuhk.edu.hk organization: Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China |
| BackLink | http://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24219128$$DView record in Pascal Francis https://www.ncbi.nlm.nih.gov/pubmed/21339204$$D View this record in MEDLINE/PubMed |
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| ContentType | Journal Article |
| Copyright | 2011, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions. 2015 INIST-CNRS 2011 2011, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions. |
| Copyright_xml | – notice: 2011, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions. – notice: 2015 INIST-CNRS – notice: 2011 2011, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions. |
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| DOI | 10.1136/gut.2011.237974 |
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| Keywords | Human Rectal disease Prevalence Colorectal cancer Hepatic disease Malignant tumor Epidemiology Colonic disease Non alcoholic steatohepatitis Gastroenterology Digestive diseases Intestinal disease Cancer |
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| References_xml | – volume: 51 start-page: 389 year: 2009 ident: b16 article-title: Magnetic resonance imaging and spectroscopy accurately estimate the severity of steatosis provided the stage of fibrosis is considered publication-title: J Hepatol – volume: 70 start-page: 5430 year: 2010 ident: b38 article-title: Interaction between adiponectin and leptin influences the risk of colorectal adenoma publication-title: Cancer Res – volume: 343 start-page: 1603 year: 2000 ident: b3 article-title: The effect of fecal occult-blood screening on the incidence of colorectal cancer publication-title: N Engl J Med – volume: 149 start-page: 638 year: 2008 ident: b6 article-title: Screening for colorectal cancer: a targeted, updated systematic review for the U.S. Preventive Services Task Force publication-title: Ann Intern Med – volume: 140 start-page: 124 year: 2011 ident: b15 article-title: Prevalence of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis among a largely middle-aged population utilizing ultrasound and liver biopsy: a prospective study publication-title: Gastroenterology – volume: 169 start-page: 657 year: 2009 ident: b22 article-title: Association between body mass index and colorectal neoplasia at follow-up colonoscopy: a pooling study publication-title: Am J Epidemiol – volume: 105 start-page: 178 year: 2010 ident: b30 article-title: Visceral obesity and insulin resistance as risk factors for colorectal adenoma: a cross-sectional, case-control study publication-title: Am J Gastroenterol – volume: 57 start-page: 1531 year: 2008 ident: b40 article-title: Adiponectin suppresses colorectal carcinogenesis under the high-fat diet condition publication-title: Gut – volume: 59 start-page: 666 year: 2010 ident: b10 article-title: Guidelines for colorectal cancer screening and surveillance in moderate and high risk groups (update from 2002) publication-title: Gut – volume: 346 start-page: 1781 year: 2002 ident: b34 article-title: Results of screening 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years of age publication-title: Gastrointest Endosc – volume: 375 start-page: 1624 year: 2010 ident: b5 article-title: Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial publication-title: Lancet – volume: 134 start-page: 1570 year: 2008 ident: b7 article-title: Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology publication-title: Gastroenterology – volume: 4 start-page: 1154 year: 2006 ident: b35 article-title: Metabolic and adipokine profile of Chinese patients with nonalcoholic fatty liver disease publication-title: Clin Gastroenterol Hepatol – volume: 54 start-page: 1560 year: 2009 ident: b24 article-title: Obesity is associated with an increased prevalence of advanced adenomatous colon polyps in a male veteran population publication-title: Dig Dis Sci – volume: 24 start-page: S105 issue: Suppl 3 year: 2009 ident: b13 article-title: The liver and the waistline: Fifty years of growth publication-title: J Gastroenterol Hepatol – volume: 97 start-page: 1407 year: 2005 ident: b1 article-title: Annual report to the nation on the status of cancer, 1975–2002, featuring population-based trends in cancer treatment publication-title: J Natl Cancer Inst – volume: 57 start-page: 1166 year: 2008 ident: b8 article-title: Asia Pacific consensus recommendations for colorectal cancer screening publication-title: Gut – volume: 103 start-page: 2061 year: 2008 ident: b25 article-title: The effect of body weight reduction on the incidence of colorectal adenoma publication-title: Am J Gastroenterol – volume: 34 start-page: 339 year: 2009 ident: b39 article-title: Adiponectin inhibits colorectal cancer cell growth through the AMPK/mTOR pathway publication-title: Int J Oncol – volume: 41 start-page: 1313 year: 2005 ident: b20 article-title: Design and validation of a histological scoring system for nonalcoholic fatty liver disease publication-title: Hepatology – volume: 59 start-page: 969 year: 2010 ident: b14 article-title: Disease progression of non-alcoholic fatty liver disease: a prospective study with paired liver biopsies at 3 years publication-title: Gut – volume: 50 start-page: 1072 year: 2009 ident: b32 article-title: Cytokeratin-18 fragment levels as noninvasive biomarkers for nonalcoholic steatohepatitis: a multicenter validation study publication-title: Hepatology – volume: 52 start-page: 579 year: 2010 ident: b17 article-title: Non-invasive assessment of hepatic steatosis: prospective comparison of the accuracy of imaging examinations publication-title: J Hepatol – volume: 8 start-page: 443 year: 2010 ident: b29 article-title: Abdominal visceral adipose tissue predicts risk of colorectal adenoma in both sexes publication-title: Clin Gastroenterol Hepatol – volume: 40 start-page: 46 year: 2004 ident: b37 article-title: Beyond insulin resistance in NASH: TNF-alpha or adiponectin? publication-title: Hepatology – volume: 139 start-page: 1138 year: 2010 ident: b11 article-title: Prospective study reveals associations between colorectal cancer and type 2 diabetes mellitus or insulin use in men publication-title: Gastroenterology – volume: 25 start-page: 562 year: 2010 ident: b31 article-title: Relationship of non-alcoholic fatty liver disease to colorectal adenomatous polyps publication-title: J Gastroenterol Hepatol – volume: 150 start-page: 1 year: 2009 ident: b4 article-title: Association of colonoscopy and death from colorectal cancer publication-title: Ann Intern Med – volume: 124 start-page: 608 year: 2003 ident: b21 article-title: Screening for colorectal cancer in Chinese: comparison of fecal occult blood test, flexible sigmoidoscopy, and colonoscopy publication-title: Gastroenterology – volume: 345 start-page: 555 year: 2001 ident: b33 article-title: One-time screening for colorectal cancer with combined fecal occult-blood testing and examination of the distal colon publication-title: N Engl J Med – volume: 4 start-page: 1154 year: 2006 article-title: Metabolic and adipokine profile of Chinese patients with nonalcoholic fatty liver disease publication-title: Clin Gastroenterol Hepatol – volume: 70 start-page: 5430 year: 2010 article-title: Interaction between adiponectin and leptin influences the risk of colorectal adenoma publication-title: Cancer Res – volume: 50 start-page: 1072 year: 2009 article-title: Cytokeratin-18 fragment levels as noninvasive biomarkers for nonalcoholic steatohepatitis: a multicenter validation study publication-title: Hepatology – volume: 348 start-page: 1625 year: 2003 article-title: Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults publication-title: N Engl J Med – volume: 5 start-page: 221 year: 2007 article-title: Association of metabolic syndrome with proximal and synchronous colorectal neoplasm publication-title: Clin Gastroenterol Hepatol – volume: 94 start-page: 2467 year: 1999 article-title: Nonalcoholic steatohepatitis: a proposal for grading and staging the histological lesions publication-title: Am J Gastroenterol – volume: 139 start-page: 1138 year: 2010 article-title: Prospective study reveals associations between colorectal cancer and type 2 diabetes mellitus or insulin use in men publication-title: Gastroenterology – volume: 52 start-page: 579 year: 2010 article-title: Non-invasive assessment of hepatic steatosis: prospective comparison of the accuracy of imaging examinations publication-title: J Hepatol – volume: 33 start-page: 184 year: 2010 article-title: Visceral fat area and markers of insulin resistance in relation to colorectal neoplasia publication-title: Diabetes Care – volume: 24 start-page: S105 issue: Suppl 3 year: 2009 article-title: The liver and the waistline: Fifty years of growth publication-title: J Gastroenterol Hepatol – volume: 57 start-page: 1166 year: 2008 article-title: Asia Pacific consensus recommendations for colorectal cancer screening publication-title: Gut – volume: 166 start-page: 36 year: 2007 article-title: Body mass and colorectal cancer risk in the NIH-AARP cohort publication-title: Am J Epidemiol – volume: 103 start-page: 974 year: 2008 article-title: Obstacles to colorectal cancer screening in Chinese: a study based on the health belief model publication-title: Am J Gastroenterol – volume: 345 start-page: 555 year: 2001 article-title: One-time screening for colorectal cancer with combined fecal occult-blood testing and examination of the distal colon publication-title: N Engl J Med – volume: 105 start-page: 178 year: 2010 article-title: Visceral obesity and insulin resistance as risk factors for colorectal adenoma: a cross-sectional, case-control study publication-title: Am J Gastroenterol – volume: 140 start-page: 124 year: 2011 article-title: Prevalence of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis among a largely middle-aged population utilizing ultrasound and liver biopsy: a prospective study publication-title: Gastroenterology – volume: 54 start-page: 1560 year: 2009 article-title: Obesity is associated with an increased prevalence of advanced adenomatous colon polyps in a male veteran population publication-title: Dig Dis Sci – volume: 57 start-page: 1531 year: 2008 article-title: Adiponectin suppresses colorectal carcinogenesis under the high-fat diet condition publication-title: Gut – volume: 343 start-page: 1603 year: 2000 article-title: The effect of fecal occult-blood screening on the incidence of colorectal cancer publication-title: N Engl J Med – volume: 23 start-page: 914 year: 2008 article-title: Genetic polymorphisms of adiponectin and tumor necrosis factor-alpha and nonalcoholic fatty liver disease in Chinese people publication-title: J Gastroenterol Hepatol – volume: 40 start-page: 46 year: 2004 article-title: Beyond insulin resistance in NASH: TNF-alpha or adiponectin? publication-title: Hepatology – volume: 134 start-page: 1570 year: 2008 article-title: Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology publication-title: Gastroenterology – volume: 25 start-page: 562 year: 2010 article-title: Relationship of non-alcoholic fatty liver disease to colorectal adenomatous polyps publication-title: J Gastroenterol Hepatol – volume: 169 start-page: 657 year: 2009 article-title: Association between body mass index and colorectal neoplasia at follow-up colonoscopy: a pooling study publication-title: Am J Epidemiol – volume: 8 start-page: 443 year: 2010 article-title: Abdominal visceral adipose tissue predicts risk of colorectal adenoma in both sexes publication-title: Clin Gastroenterol Hepatol – volume: 375 start-page: 1624 year: 2010 article-title: Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial publication-title: Lancet – volume: 103 start-page: 2061 year: 2008 article-title: The effect of body weight reduction on the incidence of colorectal adenoma publication-title: Am J Gastroenterol – volume: 34 start-page: 339 year: 2009 article-title: Adiponectin inhibits colorectal cancer cell growth through the AMPK/mTOR pathway publication-title: Int J Oncol – volume: 59 start-page: 666 year: 2010 article-title: Guidelines for colorectal cancer screening and surveillance in moderate and high risk groups (update from 2002) publication-title: Gut – volume: 20 start-page: 1497 year: 2009 article-title: Adiposity in relation to colorectal adenomas and hyperplastic polyps in women publication-title: Cancer Causes Control – volume: 346 start-page: 1781 year: 2002 article-title: Results of screening colonoscopy among persons 40 to 49 years of age publication-title: N Engl J Med – volume: 150 start-page: 1 year: 2009 article-title: Association of colonoscopy and death from colorectal cancer publication-title: Ann Intern Med – volume: 65 start-page: 1015 year: 2007 article-title: Colorectal neoplasm in asymptomatic Asians: a prospective multinational multicenter colonoscopy survey publication-title: Gastrointest Endosc – volume: 124 start-page: 608 year: 2003 article-title: Screening for colorectal cancer in Chinese: comparison of fecal occult blood test, flexible sigmoidoscopy, and colonoscopy publication-title: Gastroenterology – volume: 72 start-page: 480 year: 2010 article-title: Prevalence and risk of colorectal neoplasms in asymptomatic, average-risk screenees 40 to 49 years of age publication-title: Gastrointest Endosc – volume: 41 start-page: 1313 year: 2005 article-title: Design and validation of a histological scoring system for nonalcoholic fatty liver disease publication-title: Hepatology – volume: 51 start-page: 389 year: 2009 article-title: Magnetic resonance imaging and spectroscopy accurately estimate the severity of steatosis provided the stage of fibrosis is considered publication-title: J Hepatol – volume: 149 start-page: 638 year: 2008 article-title: Screening for colorectal cancer: a targeted, updated systematic review for the U.S. Preventive Services Task Force publication-title: Ann Intern Med – volume: 59 start-page: 969 year: 2010 article-title: Disease progression of non-alcoholic fatty liver disease: a prospective study with paired liver biopsies at 3 years publication-title: Gut – volume: 97 start-page: 1407 year: 2005 article-title: Annual report to the nation on the status of cancer, 1975–2002, featuring population-based trends in cancer treatment publication-title: J Natl Cancer Inst – reference: 21454382 - Gut. 2011 Jun;60(6):745-6 |
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| Snippet | ObjectiveNon-alcoholic fatty liver disease (NAFLD) affects 20–40% of the general adult population. Due to shared risk factors, it is postulated that NAFLD... Objective Non-alcoholic fatty liver disease (NAFLD) affects 20–40% of the general adult population. Due to shared risk factors, it is postulated that NAFLD... Non-alcoholic fatty liver disease (NAFLD) affects 20-40% of the general adult population. Due to shared risk factors, it is postulated that NAFLD patients have... OBJECTIVE: Non-alcoholic fatty liver disease (NAFLD) affects 20-40% of the general adult population. Due to shared risk factors, it is postulated that NAFLD... |
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| SubjectTerms | Adenoma Adenoma - etiology Adenoma - pathology Adult Aged Alcohol Biological and medical sciences Biopsy Cancer screening Colon cancer colonic adenomas colonic neoplasms colonic polyps Colonoscopy - methods Colorectal cancer Colorectal carcinoma Colorectal Neoplasms - epidemiology Colorectal Neoplasms - etiology Colorectal Neoplasms - pathology Diabetes diabetes mellitus Epidemiologic Methods Family medical history Fatty liver Fatty Liver - complications Fatty Liver - epidemiology Fatty Liver - pathology Female Gastroenterology. Liver. Pancreas. Abdomen Hepatitis Hepatology Histology Hong Kong - epidemiology Hospitals Humans Insulin Liver Liver - pathology Liver diseases Liver. Biliary tract. Portal circulation. Exocrine pancreas Magnetic resonance spectroscopy Magnetic Resonance Spectroscopy - methods Male Medical sciences Medical screening Metabolism Middle Aged Mortality Neoplasia Non-alcoholic Fatty Liver Disease Obesity Other diseases. Semiology Risk factors Risk groups Spectrum analysis Steatosis Stomach. Duodenum. Small intestine. Colon. Rectum. Anus Studies Tumors |
| Title | High prevalence of colorectal neoplasm in patients with non-alcoholic steatohepatitis |
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