Screening colonoscopy and detection of neoplasia in asymptomatic, average-risk, solid organ transplant recipients: case-control study.
The aim of this study was to evaluate the detection of colonic neoplasia in an average-risk population of SOT recipients. Studies regarding colonic neoplasia in solid organ transplantation (SOT) recipients have demonstrated mixed results due to the inclusion of above average-risk patients. We performed a case-control study of 102 average-risk SOT recipients who underwent screening colonoscopy, compared with an average-risk, age and sex-matched control group (n=287). Cancer rates were compared with an age-matched cohort from the National Cancer Institute's Survival, Epidemiology, and End Results (SEER) database. There was no difference in number of patients with adenomas (P=1.00). There was no difference in polyps per patient (P=0.31). Although the number of advanced lesions (excluding adenocarcinoma) between groups did not differ (P=0.25), there were two adenocarcinomas identified in the SOT group and none in the control group (P=0.068). Detection of colorectal cancer was an unexpected finding in the SOT cohort and was more likely when compared to age-matched cancer incidence generated by the SEER database. These results suggest no increased adenoma detection in SOT recipients, but with more cases of colorectal cancer than anticipated. Given previous, larger, transplant database studies demonstrating increased colorectal cancer rates, more frequent screening may be justified.
Section of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin, School of Medicine and Public Health, 1685 Highland Avenue, Madison, WI 53705, USA.
Bret J
BJ
Spier
Andrew J
AJ
Walker
Daniel D
DD
Cornett
Patrick R
PR
Pfau
Richard B
RB
Halberg
Adnan
A
Said
D000236:Adenoma / Q000175:diagnosis; D000368:Aged; D016022:Case-Control Studies; D003110:Colonic Neoplasms / Q000175:diagnosis*; D003111:Colonic Polyps / Q000175:diagnosis*; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation / Q000009:adverse effects*; D012306:Risk; D018426:SEER Program