High prevalence of colonic polyps in white males with esophageal adenocarcinoma.
OBJECTIVE
There is ongoing discussion regarding Barrett's esophagus and the prevalence of colonic neoplasms. The goal of this investigation was to evaluate colonoscopic findings in patients with esophageal carcinoma.


METHODS
In this case-control study, we used the data of patients with esophagectomy. These patients underwent routine preoperative endoscopy of the entire colon to exclude pathologic findings pending the need for colonic bridging graft reconstruction. A total of 171 patients with esophageal cancer (78 adenocarcinomas, 93 squamous-cell carcinomas, and 168 control subjects) who underwent screening colonoscopy were included. Univariate analysis and multinomial logistic regression were used to calculate odds ratios for colonic polyps.


RESULTS
The age of the three groups of patients was comparable (median age: adenocarcinoma = 62 years, squamous-cell carcinoma = 58 years, control subjects = 59 years). The male to female ratio differed significantly (adenocarcinoma = 71:7, squamous-cell carcinoma = 65:28, control subjects = 86:82; P < 0.001). Patients with adenocarcinoma had more findings on colonoscopy than patients with squamous-cell carcinoma (45 and 25 percent, respectively; P < 0.01) or control subjects (14 percent; P < 0.001). Analyzing the male data only, the difference was more pronounced. The histologic type of the esophageal tumor significantly impacted the presence of colorectal polyps even with age-adjusted and sex-adjusted data (P < 0.001), with an odds ratio of 4.03 for adenocarcinoma.


CONCLUSIONS
These results demonstrate a significant relationship between the development of Barrett's carcinoma and colonic polyps.
Bollschweiler
Elfriede
E
Department of General-, Visceral and Cancer Surgery, University of Cologne, Cologne, Germany. Elfriede.Bollschweiler@uk-koeln.de
Schloesser
Thomas
T
Leers
Jessica
J
Vallböhmer
Daniel
D
Schäfer
Hartmut
H
Hölscher
Arnulf H
AH
D000230:Adenocarcinoma / Q000150:complications*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001471:Barrett Esophagus / Q000150:complications; D002294:Carcinoma, Squamous Cell / Q000150:complications; D003111:Colonic Polyps / Q000150:complications* / Q000175:diagnosis; D003113:Colonoscopy; D004938:Esophageal Neoplasms / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors