title: Prevalence of colorectal adenomatous polyps in patients with chronic obstructive pulmonary disease.
abstract: BACKGROUND
  Colorectal adenomatous polyps are precancerous lesions of colorectal cancer. The aim of this study was to assess the prevalence of colorectal adenomatous polyps in chronic obstructive pulmonary disease (COPD) patients and determine whether COPD is associated with colorectal malignant potential.
  
  
  METHODS
  Subjects who had undergone post-bronchodilator spirometry and colonoscopy and were 40 years or older were selected from the hospital database. COPD was defined as a spirometry in which the ratio of forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) is <0.7 in post-bronchodilator spirometry. The non-COPD group was matched for both age and sex, and were defined as having an FEV1, FVC, and FEV1/FVC ≥0.7 in spirometry. Finally, 333 patients were retrospectively reviewed; of this group, 82 patients had COPD.
  
  
  RESULTS
  Among the subjects, 201 patients (60%) were nonsmokers, while 78 (23%) were current smokers. The prevalence of colorectal adenomatous polyps was 39% (98/251) in the non-COPD group and 66% (54/82) in the COPD group. Among 54 patients with adenomatous polyps in the COPD group, 47 had tubular adenoma and seven had villous adenoma. Multiple logistic regression analyses revealed that only COPD patients whom matched to the criteria of COPD by pulmonary function test (odds ratio 2.1, 95% confidence interval: 1.1-3.8; P=0.019) were independently associated with colorectal malignant potential.
  
  
  CONCLUSIONS
  The risk of colorectal malignant potential in the COPD group was higher than in the non-COPD group. We may suggest that COPD patients should consider regular colonoscopic evaluation to screen for premalignant colon polyps regardless of smoking.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Republic of Korea.
authors.forename: Eun Mi
authors.initials: EM
authors.lastname: Chun
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Republic of Korea.
authors.forename: Seo Woo
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Republic of Korea.
authors.forename: So Yeon
authors.initials: SY
authors.lastname: Lim
mesh_terms: D018256:Adenomatous Polyps / Q000175:diagnosis / Q000453:epidemiology*; D000328:Adult; D016009:Chi-Square Distribution; D003110:Colonic Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D003111:Colonic Polyps / Q000175:diagnosis / Q000453:epidemiology*; D003113:Colonoscopy; D016208:Databases, Factual; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008168:Lung / Q000503:physiopathology; D008297:Male; D016017:Odds Ratio; D011230:Precancerous Conditions / Q000175:diagnosis / Q000453:epidemiology*; D011237:Predictive Value of Tests; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D000074606:Smoking Prevention; D013147:Spirometry; D014797:Vital Capacity
keywords: COPD; chronic obstructive pulmonary disease; colorectal adenomatous polyp; smoking