David E Niccum1, Joanne L Billings1, Jordan M Dunitz1, Alexander Khoruts2. 1. Department of Medicine, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Minnesota, United States. 2. Department of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota, United States. Electronic address: khoru001@umn.edu.
Abstract
BACKGROUND: Colorectal cancer is an emerging problem in cystic fibrosis (CF). The goal of this study was to evaluate adenoma detection by systematic colonoscopic screening and surveillance. METHODS: We analyzed prospectively collected results of colonoscopies initiated at age 40years from 88 CF patients at a single Cystic Fibrosis Center. We also reviewed results of diagnostic colonoscopies from 27 patients aged 30-39years performed during the same time period at the Center. RESULTS: The incidence of polyp detection increased markedly after age 40 in CF patients. Greater than 50% were found to have adenomatous polyps; approximately 25% had advanced adenomas as defined by size and/or histopathology; 3% were found to have colon cancer. Multivariate analysis demonstrated specific risk factors for adenoma formation and progression. CONCLUSIONS: Early screening and more frequent surveillance should be considered in patients with CF due to early incidence and progression of adenomas in this patient population.
BACKGROUND:Colorectal cancer is an emerging problem in cystic fibrosis (CF). The goal of this study was to evaluate adenoma detection by systematic colonoscopic screening and surveillance. METHODS: We analyzed prospectively collected results of colonoscopies initiated at age 40years from 88 CFpatients at a single Cystic Fibrosis Center. We also reviewed results of diagnostic colonoscopies from 27 patients aged 30-39years performed during the same time period at the Center. RESULTS: The incidence of polyp detection increased markedly after age 40 in CFpatients. Greater than 50% were found to have adenomatous polyps; approximately 25% had advanced adenomas as defined by size and/or histopathology; 3% were found to have colon cancer. Multivariate analysis demonstrated specific risk factors for adenoma formation and progression. CONCLUSIONS: Early screening and more frequent surveillance should be considered in patients with CF due to early incidence and progression of adenomas in this patient population.
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