title: Colon cancer in lung transplant recipients with CF: increased risk and results of screening.
abstract: OBJECTIVE
  To determine the incidence of colon cancer in lung transplant recipients with cystic fibrosis (CF) and review screening colonoscopic findings in other recipients with CF.
  
  
  METHODS
  A retrospective chart review was performed for all patients with CF transplanted at the University of Wisconsin Hospital and Clinics (January 1994 through December 2010).
  
  
  RESULTS
  Four of 70 transplant recipients with CF developed fatal colon carcinoma following transplantation, and the cancer was advanced in all 4 recipients (age 31, 44, 44, 64) at the time of diagnosis. In contrast, only one of 287 recipients transplanted for non-CF indications developed colon cancer. Of all recipients with CF who did not develop colon cancer, 20 recipients underwent screening colonoscopy at 1 to 12 years following transplantation. Seven (35%) of the screened transplant recipients (ages 36, 38, 40, 41, 43, 49, 51) had colonic polyps in locations ranging from cecum to sigmoid colon and up to 3 cm in diameter.
  
  
  CONCLUSIONS
  In contrast to non-CF recipients, patients with CF displayed a significant incidence of colon cancer (4 of 70 recipients; 5.7%) with onset ranging from 246 days to 9.3 years post-transplant, which may be due to a combination of their underlying genetic disorder plus intense, sustained immunosuppression following lung transplantation. Colonoscopic screening may identify patients with pre-malignant colonic lesions and prevent progression to colonic malignancy.
authors.affiliation: Section of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
authors.forename: Keith C
authors.initials: KC
authors.lastname: Meyer
authors.forename: Mary L
authors.initials: ML
authors.lastname: Francois
authors.forename: Holly K
authors.initials: HK
authors.lastname: Thomas
authors.forename: Kelly L
authors.initials: KL
authors.lastname: Radford
authors.forename: Don S
authors.initials: DS
authors.lastname: Hawes
authors.forename: Tiffany L
authors.initials: TL
authors.lastname: Mack
authors.forename: Richard D
authors.initials: RD
authors.lastname: Cornwell
authors.forename: James D
authors.initials: JD
authors.lastname: Maloney
authors.forename: Nilto C
authors.initials: NC
authors.lastname: De Oliveira
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000175:diagnosis / Q000276:immunology / Q000401:mortality*; D003110:Colonic Neoplasms / Q000175:diagnosis / Q000276:immunology / Q000401:mortality*; D003550:Cystic Fibrosis / Q000401:mortality* / Q000601:surgery*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D016040:Lung Transplantation / Q000706:statistics & numerical data*; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents