Colonoscopic screening shows increased early incidence and progression of adenomas in cystic fibrosis

J Cyst Fibros. 2016 Jul;15(4):548-53. doi: 10.1016/j.jcf.2016.01.002. Epub 2016 Feb 2.

Abstract

Background: Colorectal cancer is an emerging problem in cystic fibrosis (CF). The goal of this study was to evaluate adenoma detection by systematic colonoscopic screening and surveillance.

Methods: We analyzed prospectively collected results of colonoscopies initiated at age 40years from 88 CF patients at a single Cystic Fibrosis Center. We also reviewed results of diagnostic colonoscopies from 27 patients aged 30-39years performed during the same time period at the Center.

Results: The incidence of polyp detection increased markedly after age 40 in CF patients. Greater than 50% were found to have adenomatous polyps; approximately 25% had advanced adenomas as defined by size and/or histopathology; 3% were found to have colon cancer. Multivariate analysis demonstrated specific risk factors for adenoma formation and progression.

Conclusions: Early screening and more frequent surveillance should be considered in patients with CF due to early incidence and progression of adenomas in this patient population.

Keywords: Adenoma; Colon cancer; Colorectal cancer screening; Cystic fibrosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenoma* / diagnosis
  • Adenoma* / pathology
  • Adult
  • Age Factors
  • Colonoscopy* / methods
  • Colonoscopy* / statistics & numerical data
  • Colorectal Neoplasms* / diagnosis
  • Colorectal Neoplasms* / epidemiology
  • Colorectal Neoplasms* / pathology
  • Cystic Fibrosis / epidemiology*
  • Disease Progression
  • Early Detection of Cancer / methods
  • Female
  • Humans
  • Incidence
  • Male
  • Neoplasm Staging
  • Risk Factors
  • United States / epidemiology