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This recommendation was established due to a dramatic increase in the incidence of CRC after the age of 50. According to the 2008 statistics of the Korea Central Cancer Registry, the incidence rates of CRC by age group were 28.8 per 100,000 for patients in Histone demethylase their 40's, 82.5 per 100,000 for patients in their 50's, 174.5 per 100,000 for patients in their 60's, and 245.7 per 100,000 for patients in their 70's [10]. In a multicenter prospective study in Korea [7], the incidence of adenomatous polyps was reported to be 28.1% for patients in their 40's, which was similar to our results. Considering that, in this study, no differences in the incidences of CRC existed between patients in their 40's and patients in their 50's and that the independent factor influencing the ADR was an age indicator of patients in their age 40's in this study (P http://www.selleckchem.com/products/abt-199.html 2.206-3.553), the increasing prevalence of CRC in Korea might be correlated with earlier occurrence and progression of adenomatous polyps. However, the results of this study could not be used to determine whether a 10-year earlier colonoscopy screening would reduce the incidence of CRC more effectively. In this study, some selection bias might have existed because colonoscopy screening was conducted in a large metropolitan center without involving rural areas. Therefore, a nationwide prospective study representing the general population of Korea should be started to evaluate the cost-effectiveness of a 10-year earlier colonoscopy screening for the reduction of CRC. The methods of polypectomy in this study included a snare polypectomy, a cold-forceps polypectomy, an EMR, and ESD. The selection of the method was based on the size and the shape of the polyp. Any polyp of more than 6 mm in size was not removed by using a cold-forceps polypectomy. However, some polyps of less than 5 mm could be removed by using a snare polypectomy due to their learn more subpedunculated shapes. Our results revealed the ADR was affected by the polypectomy method. Therefore, this could mean that the larger the polyps were, the more prevalent were the neoplastic changes that had occurred. The size of the polyp is an important factor that influences the progression of an adenoma [11, 12]. An adenoma at 1 cm or more in diameter with high-grade dysplasia of a villous or tubulovillous type is defined as an advanced adenoma. The overall miss rate for adenomatous polyps ranged from 15% to 24%. For an advanced adenoma with a diameter of more than 1 cm, the miss rate was reported to be 6% to 11% [13, 14]. Kaminski et al. [15] reported that the risk of interval cancer was significantly higher in patients who underwent colonoscopies performed by endoscopists whose ADRs were less than 20%, compared with the results of endoscopists whose ADRs were more than 20%.