Belisa G Muller1,2, Paulo C Contu1, Cláudio Tarta1, Anderson R Lazzaron1,2, Tiago L Ghezzi1, Daniel C Damin3,4. 1. Division of Coloproctology, Hospital de Clinicas de Porto Alegre, and Department of Surgery, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos 2350, sala (room) 600, Porto Alegre, RS, 90 035-903, Brazil. 2. Postgraduate Program in Surgical Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil. 3. Division of Coloproctology, Hospital de Clinicas de Porto Alegre, and Department of Surgery, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos 2350, sala (room) 600, Porto Alegre, RS, 90 035-903, Brazil. damin@terra.com.br. 4. Postgraduate Program in Surgical Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil. damin@terra.com.br.
Abstract
BACKGROUND AND AIM: There is no consensus whether a colonoscopy should be recommended for patients under 50 years of age who present with both anal bleeding and benign anal diseases. The aim of this study is to evaluate the effectiveness of colonoscopy to detect neoplastic lesions in this specific group of patients. METHODS: A prospective study analyzing the results of colonoscopies performed in patients younger than 50 years of age who reported a rectal bleeding and also had a diagnosis of benign anal disease at first clinical visit. RESULTS: One hundred and eighty-seven consecutive patients were prospectively included in this study. In 35 patients (18.7%), adenomatous polyps were diagnosed. Thirty-seven percent of those lesions (13 cases) were further classified as either advanced adenomas or serrated adenomas. The prevalence of adenomas was 14.6% among patients under the age of 40 and 20% among those between 40 and 50 years of age. Thirty-one percent of the adenomas (11 cases) were located in the right colon, without any other concomitant lesion in the distal colon. In addition, an unsuspected case of sigmoid carcinoma was diagnosed. CONCLUSION: The performance of colonoscopy in young patients with benign anal diseases and hematochezia resulted in a high rate of detection of neoplastic lesions. The method might be considered as a valid strategy of investigation in this frequent clinical situation.
BACKGROUND AND AIM: There is no consensus whether a colonoscopy should be recommended for patients under 50 years of age who present with both anal bleeding and benign anal diseases. The aim of this study is to evaluate the effectiveness of colonoscopy to detect neoplastic lesions in this specific group of patients. METHODS: A prospective study analyzing the results of colonoscopies performed in patients younger than 50 years of age who reported a rectal bleeding and also had a diagnosis of benign anal disease at first clinical visit. RESULTS: One hundred and eighty-seven consecutive patients were prospectively included in this study. In 35 patients (18.7%), adenomatous polyps were diagnosed. Thirty-seven percent of those lesions (13 cases) were further classified as either advanced adenomas or serrated adenomas. The prevalence of adenomas was 14.6% among patients under the age of 40 and 20% among those between 40 and 50 years of age. Thirty-one percent of the adenomas (11 cases) were located in the right colon, without any other concomitant lesion in the distal colon. In addition, an unsuspected case of sigmoid carcinoma was diagnosed. CONCLUSION: The performance of colonoscopy in young patients with benign anal diseases and hematochezia resulted in a high rate of detection of neoplastic lesions. The method might be considered as a valid strategy of investigation in this frequent clinical situation.
Entities:
Keywords:
Colonoscopy; Colorectal cancer; Colorectal neoplasms; Gastrointestinal bleeding; Young patients
Authors: Douglas K Rex; John L Petrini; Todd H Baron; Amitabh Chak; Jonathan Cohen; Stephen E Deal; Brenda Hoffman; Brian C Jacobson; Klaus Mergener; Bret T Petersen; Michael A Safdi; Douglas O Faigel; Irving M Pike Journal: Am J Gastroenterol Date: 2006-04 Impact factor: 10.864
Authors: Andrew M D Wolf; Elizabeth T H Fontham; Timothy R Church; Christopher R Flowers; Carmen E Guerra; Samuel J LaMonte; Ruth Etzioni; Matthew T McKenna; Kevin C Oeffinger; Ya-Chen Tina Shih; Louise C Walter; Kimberly S Andrews; Otis W Brawley; Durado Brooks; Stacey A Fedewa; Deana Manassaram-Baptiste; Rebecca L Siegel; Richard C Wender; Robert A Smith Journal: CA Cancer J Clin Date: 2018-05-30 Impact factor: 508.702
Authors: Donald M Davis; Jorge E Marcet; Jared C Frattini; Andrew D Prather; James J L Mateka; Valentine N Nfonsam Journal: J Am Coll Surg Date: 2011-07-07 Impact factor: 6.113
Authors: Joel L Weissfeld; Robert E Schoen; Paul F Pinsky; Robert S Bresalier; Timothy Church; Susan Yurgalevitch; Joseph H Austin; Philip C Prorok; John K Gohagan Journal: J Natl Cancer Inst Date: 2005-07-06 Impact factor: 13.506
Authors: Brenda K Edwards; Elizabeth Ward; Betsy A Kohler; Christie Eheman; Ann G Zauber; Robert N Anderson; Ahmedin Jemal; Maria J Schymura; Iris Lansdorp-Vogelaar; Laura C Seeff; Marjolein van Ballegooijen; S Luuk Goede; Lynn A G Ries Journal: Cancer Date: 2010-02-01 Impact factor: 6.860
Authors: Heather Yeo; Doron Betel; Jonathan S Abelson; Xi E Zheng; Rhonda Yantiss; Manish A Shah Journal: Clin Colorectal Cancer Date: 2017-06-23 Impact factor: 4.481
Authors: Rebecca L Siegel; Stacey A Fedewa; William F Anderson; Kimberly D Miller; Jiemin Ma; Philip S Rosenberg; Ahmedin Jemal Journal: J Natl Cancer Inst Date: 2017-08-01 Impact factor: 13.506