TY - JOUR
T1 - Duodenal Adenomas Coincide with Colorectal Neoplasia
AU - Genta, Robert M.
AU - Hurrell, Jennifer M.
AU - Sonnenberg, Amnon
N1 - Publisher Copyright:
© 2014, Springer Science+Business Media New York (Outside the USA).
PY - 2014/9/1
Y1 - 2014/9/1
N2 - Background and Aim: Small case series have alluded to an association between sporadic duodenal adenomas and colorectal neoplasia. The strength of the association remains uncertain. This case–control study was designed to test this association in a large national pathology database. Methods: This study, performed at Miraca Life Sciences, a specialized pathology laboratory that receives gastrointestinal biopsy specimens from outpatient centers throughout the US, included all subjects who underwent a bidirectional endoscopy with biopsy results from both procedures between January 2008 and December 2011. The association between duodenal and colonic neoplasms was investigated using odds ratios (OR) and their 95 % confidence intervals (CIs) derived from univariate and multivariate analyses. Results: There were 203,277 patients who underwent bidirectional procedures within the study period (mean age 58 years, 58 % females). Duodenal adenomas were present in 537 patients (median age 65 years, 51 % females; OR for male sex 1.34, 95 % CI 1.13–1.59). Hyperplastic colon polyps were present in 30,205 and colon adenomas in 85,801 patients. Hyperplastic polyps were more common in patients with duodenal adenomas (1.45, 1.07–1.95). Patients with duodenal adenomas also had a significantly greater prevalence of all types of colonic adenomas (2.65, 2.16–3.25), particularly of advanced adenomas (4.30, 3.24–5.70) and colorectal cancer (3.13, 1.38–7.12). Duodenal adenomas were associated with an equally increased risk for left and right colon adenomas. Conclusions: Patients with duodenal adenomas harbor an increased risk for any type of colonic neoplasm. This association may provide new insights into the general mechanisms underlying mucosal proliferation in the gastrointestinal tract.
AB - Background and Aim: Small case series have alluded to an association between sporadic duodenal adenomas and colorectal neoplasia. The strength of the association remains uncertain. This case–control study was designed to test this association in a large national pathology database. Methods: This study, performed at Miraca Life Sciences, a specialized pathology laboratory that receives gastrointestinal biopsy specimens from outpatient centers throughout the US, included all subjects who underwent a bidirectional endoscopy with biopsy results from both procedures between January 2008 and December 2011. The association between duodenal and colonic neoplasms was investigated using odds ratios (OR) and their 95 % confidence intervals (CIs) derived from univariate and multivariate analyses. Results: There were 203,277 patients who underwent bidirectional procedures within the study period (mean age 58 years, 58 % females). Duodenal adenomas were present in 537 patients (median age 65 years, 51 % females; OR for male sex 1.34, 95 % CI 1.13–1.59). Hyperplastic colon polyps were present in 30,205 and colon adenomas in 85,801 patients. Hyperplastic polyps were more common in patients with duodenal adenomas (1.45, 1.07–1.95). Patients with duodenal adenomas also had a significantly greater prevalence of all types of colonic adenomas (2.65, 2.16–3.25), particularly of advanced adenomas (4.30, 3.24–5.70) and colorectal cancer (3.13, 1.38–7.12). Duodenal adenomas were associated with an equally increased risk for left and right colon adenomas. Conclusions: Patients with duodenal adenomas harbor an increased risk for any type of colonic neoplasm. This association may provide new insights into the general mechanisms underlying mucosal proliferation in the gastrointestinal tract.
KW - Colon polyps
KW - Colorectal cancer
KW - Duodenal adenoma
KW - Familial adenomatous polyposis
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U2 - 10.1007/s10620-014-3131-5
DO - 10.1007/s10620-014-3131-5
M3 - Article
C2 - 24705697
AN - SCOPUS:84907873890
SN - 0163-2116
VL - 59
SP - 2249
EP - 2254
JO - Digestive Diseases and Sciences
JF - Digestive Diseases and Sciences
IS - 9
ER -