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Ten or More Cumulative Lifetime Adenomas Are Associated with Increased Risk for Advanced Neoplasia and Colorectal Cancer.

Publication ,  Journal Article
Sullivan, BA; Redding, TS; Qin, X; Gellad, ZF; Hauser, ER; O'Leary, MC; Williams, CD; Musselwhite, LW; Weiss, D; Madison, AN; Lieberman, D ...
Published in: Dig Dis Sci
June 2022

BACKGROUND: Colorectal cancer (CRC) screening guidelines recommend frequent colonoscopies and consideration of genetic testing in individuals with ≥10 cumulative adenomas. However, it is unclear how these guidelines apply to routine practice. AIMS: We estimated the proportion of participants found to have ≥10 cumulative adenomas in a screening population and described their outcomes of advanced neoplasia (AN), CRC, and extra-colonic malignancy. METHODS: We performed a secondary analysis of VA CSP#380, which includes 3121 veterans aged 50-75 who were followed up to 10 years after screening colonoscopy. We calculated the cumulative risk of ≥10 cumulative adenomas by Kaplan-Meier method. We compared baseline risk factors in those with and without ≥10 cumulative adenomas as well as the risk for AN (adenoma ≥1 cm, villous adenoma or high-grade dysplasia, or CRC) and extra-colonic malignancy by multivariate logistic regression. RESULTS: The cumulative risk of ≥10 cumulative adenomas over 10.5 years was 6.51% (95% CI 4.38%-9.62%). Age 60-69 or 70-75 at baseline colonoscopy was the only factors associated with the finding of ≥10 cumulative adenomas. Compared to those with 0-9 cumulative adenomas, participants with ≥10 cumulative adenomas were more likely to have had AN (OR 17.03; 95% CI 9.41-30.84), including CRC (OR 7.00; 95% CI 2.84-17.28), but not extra-colonic malignancies. CONCLUSIONS: Approximately 6.5% of participants in this screening population were found to have ≥10 cumulative adenomas over 10.5 years, which was uncommon before age 60. These participants were found to have AN and CRC significantly more often compared to those with lower cumulative adenomas.

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Published In

Dig Dis Sci

DOI

EISSN

1573-2568

Publication Date

June 2022

Volume

67

Issue

6

Start / End Page

2526 / 2534

Location

United States

Related Subject Headings

  • Risk Factors
  • Incidence
  • Humans
  • Gastroenterology & Hepatology
  • Early Detection of Cancer
  • Colorectal Neoplasms
  • Colonoscopy
  • Colonic Polyps
  • Colonic Neoplasms
  • Adenoma
 

Citation

APA
Chicago
ICMJE
MLA
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Sullivan, B. A., Redding, T. S., Qin, X., Gellad, Z. F., Hauser, E. R., O’Leary, M. C., … Provenzale, D. (2022). Ten or More Cumulative Lifetime Adenomas Are Associated with Increased Risk for Advanced Neoplasia and Colorectal Cancer. Dig Dis Sci, 67(6), 2526–2534. https://doi.org/10.1007/s10620-021-07069-0
Sullivan, Brian A., Thomas S. Redding, Xuejun Qin, Ziad F. Gellad, Elizabeth R. Hauser, Meghan C. O’Leary, Christina D. Williams, et al. “Ten or More Cumulative Lifetime Adenomas Are Associated with Increased Risk for Advanced Neoplasia and Colorectal Cancer.Dig Dis Sci 67, no. 6 (June 2022): 2526–34. https://doi.org/10.1007/s10620-021-07069-0.
Sullivan BA, Redding TS, Qin X, Gellad ZF, Hauser ER, O’Leary MC, et al. Ten or More Cumulative Lifetime Adenomas Are Associated with Increased Risk for Advanced Neoplasia and Colorectal Cancer. Dig Dis Sci. 2022 Jun;67(6):2526–34.
Sullivan, Brian A., et al. “Ten or More Cumulative Lifetime Adenomas Are Associated with Increased Risk for Advanced Neoplasia and Colorectal Cancer.Dig Dis Sci, vol. 67, no. 6, June 2022, pp. 2526–34. Pubmed, doi:10.1007/s10620-021-07069-0.
Sullivan BA, Redding TS, Qin X, Gellad ZF, Hauser ER, O’Leary MC, Williams CD, Musselwhite LW, Weiss D, Madison AN, Lieberman D, Provenzale D. Ten or More Cumulative Lifetime Adenomas Are Associated with Increased Risk for Advanced Neoplasia and Colorectal Cancer. Dig Dis Sci. 2022 Jun;67(6):2526–2534.
Journal cover image

Published In

Dig Dis Sci

DOI

EISSN

1573-2568

Publication Date

June 2022

Volume

67

Issue

6

Start / End Page

2526 / 2534

Location

United States

Related Subject Headings

  • Risk Factors
  • Incidence
  • Humans
  • Gastroenterology & Hepatology
  • Early Detection of Cancer
  • Colorectal Neoplasms
  • Colonoscopy
  • Colonic Polyps
  • Colonic Neoplasms
  • Adenoma