TITLE

Prevalence of Adenomas among Young Individuals at Average Risk for Colorectal Cancer

AUTHOR(S)
de Jong, Andrea E.; Morreau, Hans; Nagengast, Fokko M.; Mathus-Vliegen, Elisabeth M.H.; Kleibeuker, Jan H.; Griffioen, Gerrit; Cats, Annemieke; Vasen, Hans F.A.
PUB. DATE
January 2005
SOURCE
American Journal of Gastroenterology;Jan2005, Vol. 100 Issue 1, p139
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
OBJECTIVES: We evaluated the prevalence and characteristics of adenomas in a young population not genetically predisposed for the development of colorectal cancer (CRC).METHODS: The databases of the Dutch Hereditary Colorectal Cancer Registry were used. The study population included patients (n= 444) who had regular endoscopy until mutation analysis revealed they did not carry the (Adenomatous Polyposis Coli (APC)/Mismatch Repair) gene defect identified in their family.RESULTS: At first colonoscopy (n= 342; 50% males, mean age 37 yr) a total of 19 adenomas (10 males, mean age 50 yr, range 24–91 yr) and two CRCs (2 males, age 49 and 72 yr) were identified, and at first sigmoidoscopy (n= 102; 53% males, mean age 29 yr) three adenomas (2 males, age 8, 40, and 41 yr) were found. A second colonoscopy was performed in 14 patients with, and in 162 patients without an adenoma. Three of 14 patients (21%) developed a new adenoma (all>50 yr) and 8 of 162 (5%) patients developed their first adenoma during follow-up. In the colonoscopy group, the cumulative proportion of patients free of adenomas at age 50 yr was 86%. Of all adenomas diagnosed during colonoscopy (n= 49), 65% were located distal from the flexura lienalis. Of the adenomas detected during all endoscopies (n= 53), 9.8% were≥7 mm, 7.5% showed high-grade dysplasia, and 7.5% showed tubulovillous features.CONCLUSIONS: On the basis of our findings during colonoscopy we conclude that the risk of developing adenomas/CRC in young individuals without genetic risk factors is low. Adenoma surveillance programs should focus on young individuals with a positive family (or personal) history for adenomas/CRC, or on individuals>50 yr.(Am J Gastroenterol 2005;100:139–143)
ACCESSION #
15416365

 

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