Prevalence Of Colorectal Adenomas Research Articles

Multiple colorectal adenomas in Lynch syndrome.

Lynch syndrome has not traditionally been considered to have a high colorectal adenoma burden. However, with increasing adenoma detection rates in the general population, the incidence of adenoma detection in Lynch syndrome may also be increasing and leading to higher cumulative adenoma counts. To clarify the prevalence and clinical impact of multiple colorectal adenomas (MCRA) in Lynch syndrome. A retrospective review of patients with Lynch syndrome at our institution was performed to assess for MCRA (defined as ≥10 cumulative adenomas). There were 222 patients with Lynch syndrome among whom 14 (6.3%) met MCRA criteria. These patients had increased incidence of advanced neoplasia (OR 10, 95% CI: 2.7-66.7). MCRA is not unusual in Lynch syndrome and is associated with a significantly increased likelihood of advanced colon neoplasia. Consideration should be given to differentiating colonoscopy intervals based on the presence of polyposis in Lynch syndrome.

S344 Prevalence of Colorectal Adenomas in Young Hispanic Population

S344 Prevalence of Colorectal Adenomas in Young Hispanic Population

S276 Does Hepatitis C Independently Increase the Risk of Colorectal Adenoma?

Introduction: Hepatitis C virus (HCV) infection has been associated with extrahepatic malignancies, one such is colorectal carcinoma (CRC). The majority of CRC arise from adenomatous polyps, it is not known if HCV infection influences the growth of these precancerous lesions. This study evaluates the prevalence of colorectal adenomas in HCV patients compared to the general population and if HCV is an independent risk factor for the detection of colorectal adenomas. Methods: This case-control study included patients who underwent screening colonoscopy at our hospital. Patients were divided into cases (HCV) and controls (non-HCV). Patients with no biopsy reports, hepatitis B, and inflammatory bowel disease were excluded. Colonoscopy findings were stratified on the biopsy results i.e., hyperplastic, adenomatous, CRC or normal mucosa. Continuous variables were analyzed using Mann Whitney U test and categorical variables using Chi-square and Fisher's exact test with p< 0.05 considered statistically significant. After 1:1 propensity score matching (PSM), a matched cohort of cases and controls was generated. A multivariate regression analysis to compute an odds ratio for colorectal adenoma detection rate was done. Results: 415 patients were screened, of which 109 HCV patients and 97 controls were included. Descriptive analysis showed that age (p = 0.03), BMI (p = 0.001), aspirin (p = 0.01), smoking (p = 0.004), alcohol use (p = 0.01) and adenoma detection (p = 0.006) were significantly different between both groups. After propensity matching, multivariate regression analysis showed patients with HCV had odds ratio (OR) = 2.06 (p = 0.03), and aspirin use had OR = 0.38 (p = 0.01) in having colorectal adenoma. (Table) Conclusion: Our study shows a significantly higher rate of adenomas in chronic HCV patients. On multivariate analysis with and without propensity score matching, HCV infection was found to be an independent risk factor for colorectal adenoma. Current guidelines do not recommend earlier screening for CRC for such patients. Prospective studies would be required to assess if treatment of HCV leads to lower adenoma detection rates. Table 1. - Multivariate logistic regression for colorectal adenoma detection Variables p value Odds ratio Lower Limit of 95% CI Upper Limit of 95% CI Age ( >60, median) 0.0295* 1.043 1.034 2.125 Hepatitis C 0.0314* 2.152 1.125 3.810 Family history of CRC 0.220 1.984 0.665 5.922 Aspirin use 0.0116* 0.387 0.253 0.89 Smoking 0.499 1.229 0.677 2.231 Alcohol use 0.293 1.527 0.694 3.359 Female Gender 0.869 1.050 0.586 1.882 Diabetes Mellitus 0.529 1.244 0.630 2.459 HIV 0.895 1.148 0.150 8.806

330P Does hepatitis C independently increase the risk of colorectal adenoma?

Hepatitis C virus (HCV) infection has been associated with extrahepatic malignancies, one such is colorectal carcinoma (CRC). Majority of CRC arise from adenomatous polyps, it is not known if HCV influences the growth of these precancerous lesions. This study evaluates the prevalence of colorectal adenomas in HCV patients and if HCV is an independent risk factor for the detection of colorectal adenomas. This case-control study included patients who underwent colonoscopy. Patients were divided into cases (HCV) and controls (non-HCV). Patients with no biopsy reports, hepatitis B, and inflammatory bowel disease were excluded. Colonoscopy findings were stratified on the biopsy results i.e., hyperplastic, adenomatous, CRC or normal mucosa. Continuous variables were analyzed using Mann Whitney U test and categorical variables using Chi-square with p<0.05 considered statistically significant. After 1:1 propensity score matching (PSM), a matched cohort was generated. A multivariate regression analysis to compute an odds ratio for colorectal adenoma detection rate was done. 415 patients were screened, of which 109 HCV patients and 97 controls were included. Descriptive analysis showed that age, BMI, aspirin use , smoking, alcohol use and adenoma detection were significantly different between both groups (p<0.05). After propensity matching, multivariate regression analysis showed patients with HCV had odds ratio (OR) = 2.06 (p = 0.03), and aspirin use had OR = 0.38 (p = 0.01) in having colorectal adenoma.Table: 330PMultivariate logistic regression for colorectal adenomaVariablesp valueORUpper limit CILower limit of CIMedian age0.0295*1.0431.0342.125HCV0.0314*2.1521.1253.810Familal CRC0.2201.9840.6655.922Aspirin use0.0116*0.3870.2530.89Smoking0.4991.2290.6772.231Alcohol0.2931.5270.6943.359Female gender0.8691.0500.5861.882Diabetes mellitus0.5291.2440.6302.459HIV co-infection0.8951.1480.1508.806 Open table in a new tab Our study shows a significantly higher rate of adenomas in chronic HCV patients. On multivariate analysis, HCV infection was found to be an independent risk factor for colorectal adenoma. Current guidelines do not recommend earlier CRC screening. Prospective studies would be required to assess if treatment of HCV leads to lower adenomas.

Prevalence and risk of colorectal polyps among the Korean population under 50 years.

Colorectal cancer is a common cancer; generally, adults aged ≥ 50 years are screened using stool occult blood tests and colonoscopy. However, colorectal adenoma and cancer have been found in patients under the aged of 50, and studies on characteristics and risk factors in young patients are lacking. We evaluated the prevalence and risk factors of colorectal adenoma and cancer in young adults aged under 50 years.We retrospectively analyzed 570 individuals aged under 50 years who underwent colonoscopy at the Haeundae Paik Hospital, Korea, from January to June 2018. Logistic regression model was used to identify the risk factors for colorectal adenoma and colorectal cancer.The prevalence of colorectal adenoma in group of 19–29 years was 3.2% (1 of 31), 30–39 years was 13.8% (30 of 217) and in the group of 40–49 years was 21.1% (68 of 322) (P = .009). In multivariable analysis, age over 45 years (adjusted odds ratio [OR], 1.941; 95% confidence interval [CI], 1.187–3.172; P = .008) and male sex (adjusted OR, 1.711; 95% CI, 1.044–2.806; P = .033) were independent risk factors for colorectal neoplasia including cancer.The prevalence of colorectal adenoma increases as the age increased in young adults under 50 years of age, especially after the age of 45 years, the risk of colorectal neoplasia increases; hence, early screening should be considered before the age of 50 years.

Metformin Use Is Inversely Associated with Prevalent, but Not Incident Colorectal Adenomas.

Chemoprevention for colorectal neoplasia has attracted growing interest, with multiple medications investigated. Metformin may decrease the overall incidence of cancer in patients with diabetes and may decrease the incidence of colorectal cancer. We aimed to determine the impact of metformin use on the behavior of colorectal adenomas in a US veteran population. All patients with at least two high-quality colonoscopies between January 1997 and December 2013 at Veterans Affairs New York Harbor Healthcare System were identified. Outpatient prescription records were used to determine metformin exposure, and colonoscopy findings were recorded. Multivariable logistic regression was used to determine factors associated with adenoma detection on baseline and interval colonoscopy. In total, 1869 patients with two successive colonoscopies (median 4.5years) were included. Four hundred and sixty patients had metformin exposure prior to baseline and/or interval colonoscopy. Overall adenoma detection rate was 59.7% at baseline and 45.9% at interval colonoscopy. On multivariable analysis, metformin use was associated with decreased adenoma prevalence at baseline (OR 0.68; 95% CI 0.51-0.92; p = 0.015). Metformin did not impact adenoma incidence at interval colonoscopy whether prescribed before baseline (OR 1.26; 95% CI 0.60-2.67), after baseline (OR 1.25; 95% CI 0.91-1.72), or before and after baseline (OR 1.14; 95% CI 0.82-1.58). In this retrospective analysis of an average-risk cohort, metformin use was associated with a decreased prevalence of colorectal adenomas at baseline colonoscopy. This inverse association did not persist on interval colonoscopy. Prospective studies are needed to evaluate potential chemoprotective effects of metformin over time.

Increased prevalence of colorectal neoplasia in patients with intraductal papillary mucinous neoplasms.

Background:The association between intraductal papillary mucinous neoplasms (IPMNs) and colorectal cancer (CRC) and polyps is controversial.Objectives:To compare the prevalence of CRC and colorectal polyps among patients with IPMN and matched average risk individuals.Methods:A match cross-sectional historical study comparing colonoscopy findings of 310 patients with IPMN cysts who underwent at least one colonoscopy examination from 2004 through 2019, with 310 age- and gender-matched average risk participants who underwent a screening colonoscopy. CRC and polyps were assessed in both groups. The prevalence and odds ratio were calculated.Results:CRC was diagnosed in 16 of 310 patients with IPMN (5.2%), and at least one polyp was detected in 96 patients (31%). The prevalence of CRC was greater among patients with IPMN than in matched individuals [5.2% versus 1.3%, p = 0.012, prevalence odds ratio (POR) 4, confidence interval (CI) 1.29–16.44]. The overall prevalence of polyps was not higher among patients with IPMN than in matched individuals (31% versus 26.8%, p = 0.291, POR 1.22, CI 0.85–1.76). However, the prevalence of colorectal adenomas with high-grade dysplasia was higher in patients with IPMN than in matched individuals (4.2% versus 1%, p = 0.02, POR 4.33, CI, 1.19–23.7). The prevalence of large polyps (i.e. more than 20 mm in size) was also greater in patients with IPMN than in matched individuals (6.1% versus 1.9%, p = 0.011, POR 3.6, CI, 1.29–12.40).Conclusion:Patients with IPMN have a significantly higher prevalence of CRC and advanced polyps than the average risk population. In view of our findings, we suggest that once the diagnosis of IPMN is made, special consideration of CRC should be undertaken.

Glycosylated Hemoglobin as an Age-Specific Predictor and Risk Marker of Colorectal Adenomas in Non-Diabetic Adults.

BackgroundDiabetes is a risk factor for colorectal neoplasms. The association between the level of glycosylated hemoglobin (HbA1c) and the risk of colorectal adenomas (CRAs) in non-diabetic adults needs to be investigated.MethodsA cross-sectional study was performed on non-diabetic adults with normal HbA1c level who underwent colonoscopy between January 2010 and December 2016 during health check-ups in our hospital in China. The association between HbA1c level and CRAs was assessed by multiple logistic regression models stratified by age group (<40, ≥40 and <50, and ≥50 years old). The age group-specified thresholds for HbA1c on elevated risk of CRAs were estimated using the piecewise logistic regression.ResultsAmong the 2,764 subjects, 445 (16.1%) had CRA. The prevalence of CRA varied across the three age groups. A higher HbA1c level was found to be significantly associated with increased CRA risk in the 40–50 years group (odds ratio [OR]=1.70, 95% confidence interval [CI] 1.04–2.78, p=0.035) after adjusting for other related factors, while this association was borderline significant among the 50 years and older group (OR=1.57, 95% CI 0.97–2.54, p=0.067). Based on the piecewise logistic regression analysis results, the thresholds for HbA1c on elevated risk of CRA were 5.44% for the 40–50 years group and 4.81% for the 50 years and older group, respectively.ConclusionsHigher levels of HbA1c, even within the normal range, were associated with elevated CRA risk among non-diabetic adults. The threshold effects of HbA1c on the risk of CRA varied across different age groups, and early screening colonoscopy might be needed for individuals in their 40s and with HbA1c levels ≥5.44%.

Association between body mass index and colorectal adenomas: Findings from a case-control study in Vietnam.

Colorectal cancer is a leading cancer worldwide and in Vietnam. Adenomas (adenomatous polyps) is an important precursor of colorectal cancer. There is currently no study to determine the modifiable risk factors for colorectal adenomas, including body mass index (BMI) in Vietnam. We conducted an individually matched case-control study of 1149 colorectal adenomas and 1145 controls in a large-scale colorectal screening program involving 103 542 individuals aged 40-75 years old in Hanoi, Vietnam. Conditional logistic regression was used to evaluate the association between BMI and colorectal adenomas prevalence, after controlling for potential confounders. Overall, comparing to normal weight (ie, 18.5-22.9kg/m2 ), underweight (ie, BMI < 18.5) was associated with a non-statistically significant increased prevalence of colorectal adenomas (odd ratio [OR]=1.29 and 95% confident interval [CI]: 0.88-1.87). This association became significant among male (OR=1.98, 95% CI: 1.20-3.27), male who were ever smokers (OR=2.59, 95% CI: 1.33-5.03), nonregular exercise (OR=2.44, 95% CI: 1.26-4.73) and individuals with cardiometabolic disorders (OR=3.46, 95% CI: 1.19-10.00). The association between underweight and colorectal adenomas did not vary by smoking status, drinking status, family history of cancer, adenomas types or cardiometabolic disorders. No association was observed among obese individuals (BMI ≥ 25). In the population with low prevalence of obesity, we found that the association between BMI and colorectal adenomas followed a reversed J-shape that underweight was associated with increased prevalence. Further studies are, therefore, warranted to replicate our results and to investigate the biologic mechanism the effect of underweight on colorectal adenomas prevalence.

A sex-specific propensity-adjusted analysis of colonic adenoma detection rates in a screening cohort

The prevalence of colorectal adenoma and advanced adenoma (AA) differs between sexes. Also, the optimal age for the first screening colonoscopy is under debate. We, therefore, performed a sex-specific and age-adjusted comparison of adenoma, AA and advanced neoplasia (AN) rates in a real-world screening cohort. In total, 2824 asymptomatic participants between 45- and 60-years undergoing screening colonoscopy at a single-centre in Austria were evaluated. 46% were females and mean age was 53 ± 4 years. A propensity score for being female was calculated, and adenoma, AA and AN detection rates evaluated using uni- and multivariable logistic regression. Sensitivity analyses for three age groups (group 1: 45 to 49 years, n = 521, 41% females, mean age 47 ± 1 years; group 2: 50 to 54 years, n = 1164, 47% females, mean age 52 ± 1 years; group 3: 55 to 60 years, n = 1139, 46% females, mean age 57 ± 2 years) were performed. The prevalence of any adenoma was lower in females (17% vs. 30%; OR 0.46, 95% CI 0.38–0.55; p < 0.001) and remained so after propensity score adjustment for baseline characteristics and lifestyle factors (aOR 0.52, 95% CI 0.41–0.66; p < 0.001). The same trend was seen for AA with a significantly lower prevalence in females (3% vs. 7%; OR 0.38, 95% CI 0.26–0.55; p < 0.001) that persisted after propensity score adjustment (aOR 0.54, 95% CI 0.34–0.86; p = 0.01). Also, all age-group sensitivity analyses showed lower adenoma, AA and AN rates in females. Similar numbers needed to screen to detect an adenoma, an AA or AN were found in female age group 3 and male age group 1. Colorectal adenoma, AA and AN were consistently lower in females even after propensity score adjustment and in all age-adjusted sensitivity analyses. Our study may add to the discussion of the optimal age for initial screening colonoscopy which may differ between the sexes.

Non-Obese MAFLD Is Associated with Colorectal Adenoma in Health Check Examinees: A Multicenter Retrospective Study.

Colorectal adenoma is linked to metabolic dysfunction. Metabolic dysfunction-associated fatty liver disease (MAFLD) has a precise definition and three subtypes, including non-obese MAFLD. We aimed to investigate the impact of MAFLD on the prevalence of colorectal adenoma by comparing it to non-alcoholic fatty liver disease (NAFLD) in health check-up examinees. This is a multicenter retrospective study. We enrolled 124 consecutive health check-up examinees who underwent colonoscopy. NAFLD and MAFLD were present in 58 and 63 examinees, respectively. Colorectal adenoma was diagnosed by biopsy. The impact of the MAFLD definition on the prevalence of colorectal adenoma was investigated by logistic regression, decision-tree, and random forest analyses. In logistic regression analysis, MAFLD was identified as the only independent factor associated with the presence of colorectal adenoma (OR 3.191; 95% CI 1.494–7.070; p = 0.003). MAFLD was also identified as the most important classifier for the presence of colorectal adenoma in decision-tree and random forest analyses (29 variable importance value). Among the three subtypes of MAFLD, non-obese MAFLD was the sole independent factor associated with the presence of colorectal adenoma (OR 3.351; 95% CI 1.589–7.262; p ≤ 0.001). Non-obese MAFLD was also the most important classifier for the presence of colorectal adenoma in decision-tree and random forest analyses (31 variable importance value). MAFLD, particularly non-obese MAFLD, is the most important factor associated with the presence of colorectal adenoma rather than NAFLD. Colonoscopy examination should be considered in patients with MAFLD, especially those who are non-obese.

Increased BMI, Sedentary Lifestyle &amp; Metabolic Syndrome as Independent Risk Factors for Development of Colorectal Adenomas: A Prospective Study

<i>Background</i>: Several risk factors for development of colorectal adenomas has been studied over the years. But the effect of increased BMI, sedentary lifestyle and metabolic syndrome on the development of colorectal adenoma has been minimally studied. This study describes the influence of increased BMI, sedentary lifestyle & metabolic syndrome on the prevalence of colorectal adenoma. Secondary objective was to determine whether these factors influence the progression of benign adenomas into advanced adenomas or not. <i>Methods</i>: A total of 697 consecutive cases were included. Asymptomatic subjects aged more than 40 years who were undergoing their first colonoscopy were included in the study. Patients with a history of colonic neoplasia, IBD, colonoscopic polypectomy or colectomy were excluded from the study. Details of colonoscopy, polypectomy and histology were recorded. Data were analyzed by SPSS version 22.0. Chi-square (X²) test was done to assess the association of different risk factors with the development of colonic adenomas. Odds ratio (OR) along with its 95% CI was calculated for every individual risk factor under evaluation. A p-value<0.05 was considered as significant. <i>Result</i>: Colonic polyps were detected in 153 (21.95%) subjects. Out of these 153 subjects 81 (11.62%) had histologically proved adenomas. Benign adenomas were detected in 63 (9.03%) cases, whereas advanced adenomas were detected in 18 (2.58%) cases. A BMI of≥30 showed an OR of 2.94 (1.64-4.24) for the development of colorectal adenomas. Presence of metabolic syndrome showed an OR of 1.74 (1.14-2.34) for the development of adenomas. Sedentary lifestyle showed an OR of 1.91 (1.31-2.51) for the development of colorectal adenomas. An age of≥50 years also showed significant effect (OR=1.39) on the development of colonic adenomas. Lastly the presence of increased BMI, sedentary lifestyle and metabolic syndrome was identified as individual risk factors for the progression of adenoma towards advanced adenomas with an OR of 1.67, 2.14 & 2.92 respectively. <i>Conclusion</i>: This study demonstrates that increased BMI, sedentary lifestyle and metabolic syndrome are associated with increased risk of development of colorectal adenomas. Moreover, increasing age (>50 years) also contribute to the increased risk of development of colorectal adenomas. And lastly it has been showed that increased BMI, sedentary lifestyle and metabolic syndrome individually contribute to the increased risk of progression of benign colonic adenomas to a more advanced adenoma.

Association between dietary sugar intake and colorectal adenoma among cancer screening examinees in Japan.

Although intake of highly sugary foods is considered to be a potential risk factor for colorectal cancer through hyperinsulinemia, the association of sugar intake and colorectal adenoma, a precursor lesion to most colorectal cancer, is poorly understood, particularly in Asian populations. We undertook a cross‐sectional study in a Japanese population to investigate the association between dietary sugar intake and the prevalence of colorectal adenoma. Study subjects were selected from participants who underwent magnifying colonoscopy with dye spraying as part of a cancer screening program and who responded to a self‐administered questionnaire before the colonoscopy. A total of 738 cases with colorectal adenoma and 697 controls were enrolled. Dietary intakes of glucose, fructose, galactose, sucrose, maltose, lactose, and total sugars (sum of these six mono‐ or disaccharides) were calculated from a food frequency questionnaire, and divided into quartiles based on the distribution among controls. Odds ratios and 95% confidence intervals of colorectal adenoma were estimated using unconditional logistic regression models, with adjustment for potential confounding factors. Total sugar intake was not significantly associated with the prevalence of colorectal adenoma (odds ratio for the highest intake group compared to reference group = 1.18; 95% confidence interval, 0.81‐1.73; P for trend = .34). Furthermore, no statistically significant positive associations were observed for any of the six mono‐ or disaccharides. Findings were similar on additional analyses by site, size, and number of adenomas. Our findings do not support an association between high sugar intake and increased odds ratios of colorectal adenoma.

Outcomes at follow-up of negative colonoscopy in average risk population: systematic review and meta-analysis

ObjectiveTo review and summarise the evidence on the prevalence of colorectal adenomas and cancers at a follow-up screening colonoscopy after negative index colonoscopy, stratified by interval between examinations and by...

Colorectal polyp prevalence and aspirational detection targets determined using high definition colonoscopy and a high level detector in 2017

BackgroundColorectal adenoma prevalence can be determined by autopsy studies, or imaging studies such as colonoscopy. We describe the prevalence of colorectal adenomas determined by a single high detecting colonoscopist using high definition colonoscopes. MethodsWe conducted a cross-sectional study of consecutive patients aged ≥18 years undergoing colonoscopy with a high level detector for the indications of screening, surveillance, and diagnostic reasons from December 29, 2016 to January 12, 2018. ResultsDuring the study period, 1172 eligible patients underwent colonoscopy. Women comprised 55% (n = 646) and the majority (89%, n = 1038) were aged ≥50 years (mean age, 62.1 years). In persons aged ≥50 years undergoing screening, the prevalence of ≥1 conventional adenoma was 48.5% and ≥1 sessile serrated polyp was 15.3%. Diminutive polyps (1–5 mm in size) comprised three-quarters of all resected polyps (2236/2986). Among 246 patients (21%), 1050 hyperplastic appearing polyps were not resected from the recto-sigmoid. Adenoma prevalence was strongly associated with age and indication but serrated lesion prevalence was not. ConclusionsThe true prevalence of precancerous lesions in the colorectum determined by modern colonoscopy exceeds determination by autopsy studies. These data help define aspirational detection targets for colonoscopy. The economic burden associated with colonoscopic resection of tiny lesions is substantial.

Increased Prevalence of Colorectal Adenomas in Patients with Nonalcoholic Fatty Liver Disease: A Cross-Sectional Study

Background: Nonalcoholic fatty liver disease (NAFLD) is the most common liver disorder worldwide. Previous studies have suggested an association between colorectal adenomas and NAFLD but are limited by a lack of biopsy-proven NAFLD or comparison with matched controls. Objectives: We aimed to determine whether histologically demonstrated NAFLD is an independent risk factor for colorectal adenomas. Methods: Patients who underwent liver biopsy showing steatosis who had also undergone screening or surveillance colonoscopy in 2007–2017 were retrospectively studied by manual chart review, excluding patients with liver disease other than NAFLD. Adenoma detection rates and characteristics such as location, histologic type, and size were compared in the resulting 123 NAFLD patients against controls without liver disease matched by age, gender, and endoscopist. Results: Adenoma prevalence was significantly higher in the NAFLD group at 40.7 versus 28.1% in controls (OR 1.87, 95% CI 1.15–3.03, p = 0.01) and remained significant on multivariable analysis controlling for rates of hyperlipidemia, diabetes, and obesity (OR 1.74, 95% CI 1.05–2.88, p = 0.032). Comparing NAFLD patients with advanced fibrosis to those with simple steatosis, there was a trend toward higher adenoma prevalence in advanced fibrosis (50.0 vs. 36.8%; OR 1.84, 95% CI 0.50–6.70, p = 0.36). Conclusions: Patients with histologically demonstrated NAFLD had a significantly higher adenoma prevalence on colonoscopy compared to matched controls, which remained significant after adjusting for rates of diabetes, obesity, and hyperlipidemia. NAFLD should be investigated further as an independent risk factor for colorectal neoplasia.

Endoscopic Phenotype of Monoallelic Carriers of MUTYH Gene Mutations in the Family of Polyposis Patients: A Prospective Study.

Almost no prospective data on endoscopy in MUTYH monoallelic carriers are available. This study aimed to define the prevalence of colorectal and duodenal adenomas in a population of people presenting with a single mutation of the MUTYH gene and being first-degree relatives of biallelic MUTYH mutation carriers. This study is a prospective cohort evaluation. Patients were first-degree relatives of a patient who had polyposis with biallelic MUTYH mutation and carrying a single gene mutation of the gene from 12 French centers. This is a multicenter study. Detailed data on life habits (tobacco, alcohol, and nonsteroidal anti-inflammatory drugs), extraintestinal manifestations, and germline analysis were recorded. Complete endoscopic evaluation (colonoscopy and upper endoscopy) with chromoendoscopy was performed. Sixty-two patients were prospectively included (34 women (55%), mean age of 54, range 30-70 years). Thirty-two patients (52%) presented with colorectal polyps at colonoscopy. Of these patients with polyps, 15 (25%) had only adenomas, 8 (13%) had only hyperplastic polyps, 1 (1%) had sessile serrated adenomas, and 8 (13%) had adenomas and/or sessile serrated adenomas. We detected, in total, 29 adenomas with low-grade dysplasia, 5 adenomas with high-grade dysplasia, and 6 sessile serrated adenomas. Fourteen patients (23%) presented with a single adenoma, and 10 (16%) had 1 to 5 adenomas. No patient had more than 5 adenomas. At upper endoscopy, 3 had a limited number of fundic gland polyps; none had duodenal adenomas. The 2 main missense mutations c.1145G>A, p.Gly382Asp and c.494A>G, p.Tyr165Cys were associated with the development of colorectal adenomas/serrated polyps in these monoallelic carriers. This study was limited by the small number of patients. This prospective study provides unique prospective data suggesting that monoallelic mutation carriers related to patients with polyposis show no colorectal polyposis and have very limited upper GI manifestations justifying an endoscopic follow-up. See Video Abstract at http://links.lww.com/DCR/A862.

Liver fibrosis is associated with risk for colorectal adenoma in patients with nonalcoholic fatty liver disease.

Nonalcoholic fatty liver disease (NAFLD) is associated with risks for developing colorectal adenoma. This study aimed to evaluate the association between advanced fibrosis in NAFLD and the risk for colorectal adenoma.We retrospectively analyzed the data of 6332 adults who underwent abdominal ultrasound and 1st-time colonoscopy on the same day in a health screening program at a single center. We evaluated the presence of advanced fibrosis in NAFLD using various noninvasive score, which also analyzed the detection rate of colorectal adenoma according to the presence of advanced fibrosis in NAFLD.The subjects with NAFLD had a higher prevalence of colorectal adenoma. In the multivariate analysis, NAFLD was an independent risk factor for colorectal adenoma (adjusted odds ratio [OR], 1.15; 95% confidence interval [CI], 1.02-1.30), advanced adenoma (adjusted OR, 1.50; 95% CI, 1.12-2.01), and multiple adenomas (adjusted OR, 1.32; 95% CI, 1.01-1.73). When NAFLD was further stratified based on the stage of fibrosis using the noninvasive score models, the subjects with NAFLD and advanced fibrosis had a significantly higher risk for colorectal adenoma, advanced adenoma, and multiple adenomas than those with NAFLD without advanced fibrosis.NAFLD with advanced fibrosis might be risk factor for colorectal adenoma compared with NAFLD without advanced fibrosis.

Patients with Gastric Polyps need Colonoscopy Screening at Younger Age: A Large Prospective Cross-Sectional Study in China.

Background To date, it is not clarified whether patients with gastric polyps without any alarming symptoms for colorectal neoplasia need colonoscopy screening. The objective of this study is to prospectively determine the association between gastric polyps and colorectal neoplasia.Methods A multicenter prospective cross-sectional study was performed from July 2012 to December 2014. We compared patients with and without gastric polyps for prevalence of colorectal adenomas. The odds ratios (OR) were computed by logistic regression analysis after multivariable adjustments.Results Totally 1546 patients were included, with 770 patients in the gastric polyp group and 776 in the age- and sex- matched control group. Patients with gastric polyps had greater odds of having any colorectal adenoma (adjusted OR=2.34, 95% confidence interval [CI]: 1.79 to 3.06, p<0.001) and advanced colorectal adenomas (adjusted OR=2.71, 95% CI: 1.74 to 4.23, p<0.001) than those without. The positive association between gastric polyps and colorectal adenomas remained significant in both women (OR=2.34, 95% CI: 1.66 to 3.29, p<0.001) and men (OR=1.87, 95% CI: 1.31 to 2.66, p=0.001). Patients over the age of 40 with gastric polyps had a higher prevalence of colorectal adenomas than those without (40-49yr: OR=1.81, 95% CI=1.02-3.21, p=0.04; 50-59yr: OR=1.88, 95% CI=1.26-2.81, p<0.001; 60-74yr: OR=2.62, 95% CI=1.73-3.98, p<0.001).Conclusions The presence of gastric polyps is significantly associated with a higher prevalence of colorectal adenomas, especially advanced colorectal adenomas. Colonoscopy might be considered in patients with gastric polyps, of any gender, and over the age of 40.

Telomere length in the colon is related to colorectal adenoma prevalence.

Telomere length has been associated with risk of several cancers. However, studies of the relationship between telomere length and colorectal cancer risk have been inconsistent. This study examined the relationship between telomere length in normal colon tissue and the prevalence of colorectal adenoma, a precursor to colorectal cancer. This nested case-control study consisted of 85 patients aged 40 to 65 undergoing a screening colonoscopy: 40 cases with adenoma(s) detected at colonoscopy and 45 controls with normal colonoscopy. During the colonoscopy, two pinch biopsies of healthy, normal appearing mucosa were obtained from the descending colon. Relative telomere length (rTL) was quantified in DNA extracted from colon mucosa using quantitative real-time PCR. Logistic regression was used to assess the relationship between telomere length and adenoma prevalence and estimate odds ratios and 95% confidence intervals. rTL was significantly longer in colon tissue of individuals with adenomas compared to healthy individuals (p = 0.008). When rTL was categorized into quartiles according to the distribution of rTL among controls, individuals with the longest telomeres had increased odds of adenoma when compared to individuals with shortest telomeres (OR = 4.58, 95% CI: 1.19, 17.7). This study suggests that long telomeres in normal colon tissue are associated with increased colorectal cancer risk.