Prevalence Of Adenomas In Patients Research Articles

Diverticulosis and neoplastic lesions in screening colonoscopy: a large, multicenter study.

Data on the potential association between diverticulosis and colonic neoplastic lesions are still controversial. We investigated this issue in subjects who underwent screening colonoscopy. We reviewed the data of subjects with a positive fecal immunological test who underwent a first colonoscopy in the national colorectal screening program. Endoscopic and histological reports were evaluated, using both univariate and multivariate analyses to search for an association between diverticulosis and colonic neoplastic lesions. Data from 5050 subjects (males: 52.2%; mean age: 61.7±6.5 years) observed in the 7 participating centers were considered. Diverticula were found in 2176 (43.1%) cases; at least 1 adenoma was detected in 2277 (45.1%) patients, at least 1 advanced adenoma in 842 (16.7%); and cancer was diagnosed in 159 (3.1%) cases. By univariate analysis, the prevalence of adenomas in patients with diverticula (46.7%, 95% confidence interval [CI] 44.6-48.8%) was significantly higher than in controls (43.8%, 95%CI 42.1-45.7%; P=0.041), while prevalences of both advanced adenomas (13.8%, 95%CI 16.3-19.5%) and cancers (2.4%, 95%CI 1.7-3.1% vs. 3.7%, 95%CI 3.1-4.4%) were lower. By multivariate analysis, only male sex (odds ratio [OR] range: 1.54-2.05) and age (OR range: 1.03-1.05) were found to be independent variables associated with different neoplastic lesions in the colon, whilst diverticulosis was not. This large, multicenter study found no significant association between diverticulosis and neoplastic lesions in subjects who underwent screening colonoscopy.

Increased prevalence of colonic adenomas in patients with cystic fibrosis

BackgroundCystic fibrosis (CF) is the most common lethal genetic illness in the Caucasian population. Studies have shown that CF patients are at an elevated risk of developing colon cancer. Colonic adenomas are the precursors of colon cancer. This study aims to determine the prevalence of adenomas in patients with cystic fibrosis. MethodsAll patients were recruited prospectively at The Ottawa Hospital Cystic Fibrosis Clinic from 2010 through 2015. Baseline demographic and cystic fibrosis disease characteristics were collected from the clinic's CF patient database. Upon presentation at the endoscopy unit, and after a brief history and physical exam, a colonoscopy was performed. Polyps were resected if detected and sent to the pathology department for characterization. Findings were compared with a control group (pairing each CF patient with 5 age and sex-matched controls) of near-average risk patients who underwent a colonoscopy at the same center. ResultsOf the 33 patients that provided informed consent to participate in the study, 30 patients underwent colonoscopy and 13/30 (43.3%) were found to have colonic adenomas compared to 7 (4.7%) of the 150 control patients. The relative risk ratio for adenoma detection in a CF patient as compared to a matched control patient was 9.29 (95% CI 4.04–21.31), p<0.01. ConclusionsColonic adenomas are more prevalent in CF patients compared to the general population. This study suggests the need for additional research to support recently published screening guidelines for CF patients.

Colonic diverticulosis and the metabolic syndrome: an association?

Colonic diverticulosis (CD) is related to advanced age and a lack of dietary fiber. Recently, several studies have shown that metabolic syndrome (MS) is also implicated in the etiopathogenesis of CD. This study aimed to assess the association between MS, obesity and CD. This was a prospective study of a one-year duration. The MS was defined according to the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III). Demographic data, risk factors for MS and endoscopic findings of patients who underwent a total colonoscopy in the department were collected. Obesity was defined as a body mass index ≥ 30 kg/m2. Informed consent was obtained. The local Ethics Committee and National Data Protection Committee approved the study. Statistical analysis was performed with SPSS 21 and statistical significance was defined as p < 0.05. The study included 203 patients, 95 males with a mean age of 65.5 years. CD was diagnosed in 30.5% of patients. Univariate analysis showed that age, hypertension, increased waist circumference and hyperlipidemia were associated with colonic diverticulosis. There was no association with gender, obesity or type 2 diabetes mellitus. Multivariate analysis showed that age and a greater waist circumference increased the risk of diverticulosis. Age-adjusted analysis showed that MS was associated with diverticulosis. The prevalence of adenoma in patients with CD was similar to that in patients without CD. In this series, MS was significantly associated with CD. The identification of risk groups is important since diverticulosis can have serious and potentially fatal complications. To our knowledge, this is the first Southern European prospective study evaluating the association between MS and CD.

Prevalence of colorectal adenoma in patients with multiple gastric adenoma or cancers.

517 Background: It has been reported that patients with single gastric cancer or adenoma are at increased risk of colorectal cancer or adenoma. However, the incidence of colorectal adenoma in patients with multiple gastric neoplasms has not been discussed yet. Methods: We retrospectively analyzed the esophagogastroduodenoscopic and colonoscopic findings as well as the clinicopathologic features between October 2012 and July 2014. The aim of this study was to investigate whether the incidence of colorectal adenoma is higher or not in patients with multiple gastric neoplasms than those with a single gastric neoplasm. Results: A total of 164 patients with gastric neoplasm were divided into two groups whether the number of lesions was single or multiple. Among the 138 patients with single gastric neoplasm, 51 patients performed colonoscopy for surveillance study and 9 patients underwent colonoscopy among the 26 patients with multiple gastric neoplasms. Colorectal adenoma were detected in 58.8% (30/51) of the single gastric neoplasm group, and in 88.8% (8/9) of the multiple gastric neoplasms group (p &lt; 0.001). The mean number of colorectal adenomas was significantly higher in the multiple gastric neoplasm group than in the single group. (4.78 vs. 1.94, p = 0.013). The age, sex, BMI, presence of underlying diseases and the degree of gastric dysplasia were not significantly different between the two groups. Conclusions: The prevalence and the number of colorectal adenoma were significantly higher in patients with multiple gastric neoplasms than in those with single gastric neoplasm. Clinical trial information: KUGH14308-001.

Prevalence of Colorectal Adenomas in Patients with Diabetes Mellitus and Chronic Kidney Disease and Its Association with Parathormone Levels

Prevalence of Colorectal Adenomas in Patients with Diabetes Mellitus and Chronic Kidney Disease and Its Association with Parathormone Levels

High Prevalence of Colonic Adenoma in Patients with End-Stage Renal Disease (ESRD) on Hemodialysis (HD) Undergoing Renal Transplant (RT) Evaluation

High Prevalence of Colonic Adenoma in Patients with End-Stage Renal Disease (ESRD) on Hemodialysis (HD) Undergoing Renal Transplant (RT) Evaluation

Prevalência de adenomas colorretais em pacientes com história familiar para câncer colorretal

O câncer colorretal (CCR) é uma doença comum e letal, influenciada por fatores genéticos e ambientais, e pela interação entre ambos. Seu risco está fortemente associado ao número e à idade dos parentes de primeiro grau com história de CCR. O objetivo foi estudar a prevalência de adenomas em pacientes com história familiar de câncer colorretal. Métodos: Realizou-se um estudo retrospectivo, tendo como alvo todos os pacientes submetidos à colonoscopia em um hospital de referência da cidade de Porto Alegre, entre 2003 e 2007. Resultados: Dos 2.462 pacientes estudados, 118 apresentaram história familiar para CCR e 2.344 não apresentaram. Nos dois grupos, houve predomínio do sexo feminino (P=0,001). Nos pacientes com adenomas e história familiar para CCR, houve predomínio do sexo feminino. Já nos pacientes com adenomas e sem história familiar, o sexo masculino foi mais frequente (P=0,032). O número de adenomas entre eles não foi estatisticamente significativo (P=0,187). Conclusão: O grupo com história familiar para CCR mostrou mais mulheres (P=0,001) e a idade também foi inferior (P=0,002). A comparação entre o grupo com adenomas e história familiar para CCR mostrou um número maior de mulheres que o grupo com adenomas sem história familiar para CCR (P=0,032).

Determination of the minimal essential serum folate concentration for reduced risk of colorectal adenoma

There are no data regarding basal folate levels in patients without colorectal adenoma. This study aimed to determine the minimum serum folate concentration that associates with reduced risk of colorectal adenoma. 1510 consecutive patients underwent total colonoscopy for suspected colorectal lesions after barium enema examination. Prior to colonoscopy, history of alcohol consumption was noted and blood serum analyzed for folate and vitamin B12 levels. Polypoid lesions were evaluated histologically. We excluded patients with anemia, history of colonoscopy, overconsumption of alcohol, or malignancies. In all, 458/1510 patients (male/female; 258/200, 40-75 years) were determined eligible. Variables were compared between patients with adenoma and those without adenoma. Serum folate concentration was the variable with the most significant statistical variation between males with adenoma (8.0ng/ml) and males without adenoma (9.2) (p=0.001). Serum folate concentrations in females with adenoma did not differ significantly from those in females without adenoma (10.7 versus 10.9). When subjects were stratified into groups according to serum folate, we found no significant difference in the prevalence of adenoma in patients with folate levels greater than 8.0ng/ml. Patients with serum folate concentrations above 8.0ng/ml had the lowest risk of developing colorectal adenoma.

There is no increased risk for colorectal cancer and adenomas in patients with diverticulitis: a retrospective longitudinal study

This study was designed to assess the relationship between diverticulitis and the development of colorectal cancer (CRC) and colonic adenomas. A retrospective study was longitudinally conducted. Patients who had been admitted to the hospital between 1990 and 2000 with diverticulitis were retrieved and the incidence of CRC and prevalence of colonic adenomas in these patients was determined. Data were collected from the electronic clinical and pathology records. The incidence of CRC and prevalence of adenomas in this patient cohort was compared with the general population. The patients were followed until 2008. A total of 288 patients with diverticulitis were included (167 of whom were female patients [58%]). The mean age of patients at admittance for diverticulitis was 66 years (range: 27-92). CRC was detected in five patients (1.7%) (95% CI 0.8-3.5) with a mean age of 77 years; colonic adenomas were found in 18 patients (6.3%) (95% CI 4.3-9.0) with a mean age of 62 years. The lifetime risks of developing CRC and adenomas were presumed to be 4% and 20% respectively. Expected rates for CRC and adenomas in our patients were calculated as 17 (95% CI 4.0-8.6) and 69 patients (95% CI 20.1-28.3) respectively. This study showed a lower prevalence of CRC and colonic adenomas in patients with diverticulitis compared with the lifetime risk which means that diverticulitis is not a risk factor for development of CRC and adenomas. Long-term colonic screening after a negative colonoscopy for diverticulitis (generally performed several weeks after recovery) does not seem to be justified.

DO PATIENTS WITH LYMPHOCYTIC COLITIS HAVE A HIGH RISK FOR ADENOMAS?

Purpose: Lymphocytic colitis (LC) is a chronic inflammatory disease of the colon. It is not known whether LC is associated with an increased risk for adenomas, thereby necessitating surveillance colonoscopy. The aim of the study was to assess the prevalence of adenomas in patients with LC compared to controls. Methods: From 1994–2004, 354 patients with LC and 309 patients with chronic diarrhea who underwent colonoscopy to exclude microscopic colitis and the biopsies were normal, were identified from our pathology database. Age-specific prevalence of adenomas between the two groups was compared using a logistic regression model. Results: Thirty-fourpatients (9.6%) in the LC group and 31 patients (10.0%) in the control group had adenomas (P = 0.85). There was no difference in the prevalence of adenomas in the LC and control groups (P = 0.56), after adjusting for age. There were no differences in the mean size, mean number, and frequency of advanced adenomas between the 2 groups. In a separate study of screening colonoscopy in 272 patients >50 yrs at average risk from our institution, adenomas were identified in 67 patients (25%), which was significantly higher than that of the LC (31/219, 14.2%) or the control (25/175, 14.3%) groups with age >50 yrs in the current study (P <0.01). Conclusions: Lymphocytic colitis does not increase the risk for adenomas. Routine surveillance colonoscopy is not warranted in patients with LC.Table: Prevalence of Adenomas

Jejunal polyps in familial adenomatous polyposis assessed by push-type endoscopy.

Cancer of the upper gastrointestinal tract is a leading cause of death in patients with familial adenomatous polyposis who have previously undergone total colectomy. The prevalence and the degenerative risk of gastric and duodenal adenomas has been well documented, but little is known about the occurrence of jejunal polyps in these patients. We evaluated 21 (16 affected and five high-risk) subjects in nine families prospectively in order to assess the frequency of polyps in the upper jejunum. With the push-type technique, it has been possible to insert a standard gastroduodenoscope or a longer fiberscope 15-80 cm beyond the ligament of Treitz. Eight out of 16 (50%) affected patients and none of the nonaffected subjects had polyps. All lesions were adenomas, including a 4-cm tubulovillous adenoma with severe dysplasia, and were almost exclusively located in the first 20 cm of jejunum. The depth of insertion obtained with gastroduodenoscopes was significantly smaller than that obtained with longer endoscopes (pediatric colonoscope or experimental enteroscope). However, the jejunal area thought to be at the highest risk of adenoma (the proximal 20 cm) was usually investigated even with standard 105-cm long gastroduodenoscopes. This study confirms that the upper jejunum has a high prevalence of adenomas in patients affected by familial adenomatous polyposis and that proximal jejunoscopy is a worthwhile, not excessively uncomfortable procedure that should be added to the usual follow-up protocols.