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Lee, Hong, Kim, Kim, Kim, Hong, Yang, Shin, Lee, Kim, Park, Kim, Yang, Kim, Jeon, and Multi-Society Task Force for Development of Guidelines for Colorectal Polyp Screening, Surveillance and Management: Korean Guidelines for Colorectal Cancer Screening and Polyp Detection
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Journal of the Korean Society of Radiology 2012; 66(4): 385-406.

Published online: 30 April 2012

DOI: https://doi.org/10.3348/jksr.2012.66.4.385

Korean Guidelines for Colorectal Cancer Screening and Polyp Detection

Bo In Lee, MD1, Sung Pil Hong, MD2, Seong Eun Kim, MD3, Se Hyung Kim, MD4, Hyun Soo Kim, MD5, Sung Noh Hong, MD6, Dong Hoon Yang, MD7, Sung Jae Shin, MD8, Suck Ho Lee, MD9, Young Ho Kim, MD10, Dong Il Park, MD10, Hyun Jung Kim, MD11, Suk Kyun Yang, MD7, Hyo Jong Kim, MD12, Hae Jeong Jeon, MD13; Multi-Society Task Force for Development of Guidelines for Colorectal Polyp Screening, Surveillance and Management

1Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.

2Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

3Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.

4Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.

5Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.

6Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.

7Department of Gastroenterology, University of Ulsan College of Medicine, Seoul, Korea.

8Department of Internal Medicine, Ajou University School of Medicine, Suwon, Korea.

9Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea.

10Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea.

11Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea.

12Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, Korea.

13Department of Radiology, Konkuk University School of Medicine, Seoul, Korea.

Corresponding author: Hyun-Soo Kim, MD. Department of Internal Medicine, Yonsei University Wonju College of Medicine, 162 Ilsan-dong, Wonju 220-701, Korea. Tel. 82-33-741-1229, Fax. 82-33-741-1228, hyskim@yonsei.ac.kr

Received 17 December 2011       Accepted 29 January 2012

Copyright © 2012 The Korean Society of Radiology

Abstract

Colorectal cancer is currently the second most common cancer among Korean males and the fourth most common among females. Since the majority of colorectal cancer case present following the prolonged transformation of adenomas into carcinomas, early detection and removal of colorectal adenomas are vital methods in its prevention. Considering the increasing incidence of colorectal cancer and polyps in Korea, it is very important to establish national guidelines for colorectal cancer screening and polyp detection. The proposed guidelines have been developed by the Korean Multi-Society Task Force using evidence-based methods. Systematic reviews and meta-analyses have been used to form the statements contained in the guidelines. This paper discusses the epidemiology of colorectal cancers and adenomas in Korea as well as optimal methods for screening of colorectal cancer and detection of adenomas including fecal occult blood tests, radiologic tests, and endoscopic examinations.

Keywords: Early Detection of Cancer, Colorectal Neoplasms, Occult Blood, Colonoscopy, Colonography, Computed Tomographic

Figures and Tables

Fig. 1

Study selection.

Note.-CS = colonoscopy, CTC = CT colonography, DCBE = double contrast barium enema, FSG = flexible sigmoidoscopy, KISS = Korean Studies Information System, KMbase = Korean Medical database, RCT = randomized controlled trial
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Fig. 2

Meta-analysis. Detection rate of FIT for advanced colorectal neoplasia according to the number of samples (1 test vs. 2 tests).

Note.-CI = confidence interval, FIT = fecal immunochemical test
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Fig. 3

Meta-analysis. Comparison between gFOBT and FIT in detection of colorectal cancer in average risk group.

Note.-CI = confidence interval, FIT = fecal immunochemical test, gFOBT = guaiac-based fecal occult blood test
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Fig. 4

Meta-analysis of CT colonography. Reported sensitivity and specificity in the included studies, by polyp size.

A. Per-patient sensitivity for CT colonography.
B. Per-patient specificity for CT colonography.
C. Per-polyp sensitivity for CT colonography.
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Table 1

Quality of Evidence and Strength of a Recommendation

jksr-66-385-i001

Notes

This study was initiated with the support of the Korean Society of Gastroenterology, the Korean Society of Gastrointestinal Endoscopy, and the Korean Association for the Study of Intestinal Disease. This study was supported by a grant from the Korean Health Technology R&D Project, Ministry for Health, Welfare & Family Affairs, Republic of Korea (A102065-23).

We extend profound thanks to Professor Hwang Choi (Department of Internal Medicine, The Catholic University of Korea College of Medicine), Professor Sung-Ae Jung (Department of Internal Medicine, Ewha Womans University School of Medicine) and Professor Seon-Ja Park (Department of Internal Medicine, Kosin University College of Medicine), who gave unsparing advice regarding the development of this guideline for colorectal cancer screening and polyp detection. We express our deep appreciation to Professor So Yeon Kim (Department of Radiology, University of Ulsan College of Medicine) for her great devotion to the completion of this guideline.

We also give great thanks to the Korean Association of Internal Medicine and Korean Physicians Association for their agreement with final version of this guideline. This study was initiated with the support of the Korean Society of Gastroenterology, the Korean Society of Gastrointestinal Endoscopy, and the Korean Association for the Study of Intestinal Disease.

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