title: Is a stricter colonoscopy screening protocol necessary in liver transplant recipients? Comparison with an average-risk population.
abstract: BACKGROUND
  The epidemiology of colorectal neoplasm in liver transplantation recipients has not been fully determined.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the prevalence of colorectal neoplasm in liver transplantation recipients and to compare it with that in the average-risk population.
  
  
  METHODS
  This study was retrospective and observational.
  
  
  METHODS
  This study was conducted at a tertiary care center.
  
  
  METHODS
  From January 2000 to December 2011, 257 liver transplantation recipients who had undergone posttransplant colonoscopy were enrolled. A total of 1028 control subjects matched for age, sex, and calendar year of the index colonoscopy were recruited from those who had undergone screening colonoscopy at our institution.
  
  
  METHODS
  Colonoscopy findings were compared between the 2 groups. The prevalence of overall and advanced colorectal neoplasms and their risk factors were investigated.
  
  
  RESULTS
  The median age was 54 years, and each group consisted of approximately 75.5% men. The prevalence of overall and advanced colorectal neoplasm was 35.4% and 5.8% in liver transplantation recipients and 41.7% and 3.5% in controls (p = 0.07 and p = 0.11). The prevalence of invasive colorectal cancer was higher in liver transplantation recipients than in controls (0.8% versus 0.0%, p = 0.04). The prevalence of overall and advanced colorectal neoplasms in liver transplantation recipients younger than 40 years was higher than age-matched controls (p = 0.003 and p = 0.04).
  
  
  CONCLUSIONS
  The retrospective design was a limitation of this study.
  
  
  CONCLUSIONS
  The prevalence of colorectal neoplasms may not increase in liver transplantation recipients compared with the general population. However, the prevalence of invasive colorectal cancer may be higher in liver transplantation recipients. A prospective study is warranted to determine an appropriate colorectal cancer screening strategy for liver transplantation recipients.
authors.affiliation: 1Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea 2Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea 3Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Ho-Su
authors.initials: HS
authors.lastname: Lee
authors.forename: Dong-Jun
authors.initials: DJ
authors.lastname: Yoo
authors.forename: Hye Won
authors.initials: HW
authors.lastname: Park
authors.forename: Dong-Hoon
authors.initials: DH
authors.lastname: Yang
authors.forename: Seung-Jae
authors.initials: SJ
authors.lastname: Myung
authors.forename: Suk-Kyun
authors.initials: SK
authors.lastname: Yang
authors.forename: Sung-Gyu
authors.initials: SG
authors.lastname: Lee
authors.forename: Jeong-Sik
authors.initials: JS
authors.lastname: Byeon
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003113:Colonoscopy / Q000592:standards*; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment