Colonic neoplasia in asymptomatic persons with negative fecal occult blood tests: influence of age, gender, and family history.
Six hundred twenty-one asymptomatic persons with negative fecal occult blood tests (ages 50-75 yr), including 496 with no known risk factors for colorectal cancer and 125 with a single first-degree relative with a history of colonic neoplasia developed after age 40, underwent screening colonoscopy. Three Dukes A cancers were detected in average-risk persons. The overall prevalence of adenomatous polyps was 27%. Multiple logistic regression analysis revealed that increasing age and male gender were both strong predictors of colonic neoplasia (p < 0.001). A positive family history of a single first-degree relative with colorectal cancer was not associated with an increased prevalence of colonic neoplasia (p = 0.29), although an effect may be present if the relative was < 60 yr at diagnosis. Overall 16% of males and 7% of women > or = 60 yr had at least one adenoma that was large (> or = 1 cm in size), villous or tubulovillous, or had grade 3 dysplasia. We conclude that the prevalence of colonic neoplasia in asymptomatic persons with negative fecal occult blood tests is substantial, particularly in elderly males. A family history of a single first-degree relative diagnosed at age > or = 60 yr with colorectal cancer is not associated with an increased prevalence of colonic adenomas.
Rex
D K
DK
Department of Medicine, Indiana University School of Medicine, Indianapolis.
Lehman
G A
GA
Ulbright
T M
TM
Smith
J J
JJ
Pound
D C
DC
Hawes
R H
RH
Helper
D J
DJ
Wiersema
M J
MJ
Langefeld
C D
CD
Li
W
W
D000236:Adenoma / Q000175:diagnosis / Q000453:epidemiology; D000367:Age Factors; D000368:Aged; D003111:Colonic Polyps / Q000175:diagnosis / Q000453:epidemiology*; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009780:Occult Blood; D015995:Prevalence; D012044:Regression Analysis; D012307:Risk Factors; D012737:Sex Factors