TY - JOUR
T1 - Patients with Non-Hodgkin’s Lymphoma Are at Risk of Adenomatous Colon Polyps
AU - Abu-Sbeih, Hamzah
AU - Chen, Ellie
AU - Ahmed, Osman
AU - Mallepally, Niharika
AU - Lum, Phillip
AU - Qiao, Wei
AU - Lee, Hun Ju
AU - Bresalier, Robert
AU - Wang, Lan Sun
AU - Weston, Brian
AU - Raju, Gottumukkala S.
AU - Wang, Yinghong
N1 - Funding Information:
Medical editing of this paper was provided by the Department of Scientific Publications at MD Anderson Cancer Center.
Publisher Copyright:
© 2019, Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2019/10/1
Y1 - 2019/10/1
N2 - Background: Patients with non-Hodgkin’s lymphoma (NHL) are frequently referred for colonoscopy to evaluate gastrointestinal symptoms during their treatment course. Here, we described the rate of colonic adenomas in patients with NHL. Methods: This was a retrospective study of patients with NHL who underwent colonoscopy after being diagnosed with NHL between January 2000 and December 2017. Results: Of the 17,938 patients who had been diagnosed with NHL in the study period, 2176 met the inclusion criteria. The mean age at the time of colonoscopy was 61 years. Most patients were male (61%). Overall, 1273 polyps were detected in 811 patients (37%). Sessile serrated adenomas were detected in 102 (5%) patients. The overall ADR was 12% in patients younger than 40 years of age (n = 103), 26% in patients aged 40–50 (n = 251), 34% in patients aged 51–60 (n = 630), and 43% in patients older than 60 (n = 1212). Most polyps were located in the right colon (63%), and 101 (8%) were larger than 1 cm. Villous adenomatous features were present in 1% of polyps, while high-grade dysplasia was detected in 22%. Invasive adenocarcinoma was identified in 4%. The median interval from lymphoma diagnosis to adenoma detection was 1.4 years (interquartile range 0.5–3.8 years). A repeat colonoscopy was performed in 343 patients. The overall ADR on repeat colonoscopy was 30%. Cox regression analysis revealed that age (hazards ratio 1.04; 95% confidence interval 1.03–1.05; P < 0.001) and male sex (hazards ratio 1.35; 95% confidence interval 1.13–1.60; P = 0.001) were independent factors associated with worse overall survival. By contrast, screening colonoscopy was associated with longer survival duration (hazards ratio 0.48; 95% confidence interval 0.36–0.63; P < 0.001). Conclusion: The ADR in NHL patients aged 40–50 years was equivalent to that reported in the literature in non-cancer patients aged 50–70 years. Early screening colonoscopy may be warranted in NHL patients younger than 50 years. Screening colonoscopy significantly improved the overall survival of patients with NHL.
AB - Background: Patients with non-Hodgkin’s lymphoma (NHL) are frequently referred for colonoscopy to evaluate gastrointestinal symptoms during their treatment course. Here, we described the rate of colonic adenomas in patients with NHL. Methods: This was a retrospective study of patients with NHL who underwent colonoscopy after being diagnosed with NHL between January 2000 and December 2017. Results: Of the 17,938 patients who had been diagnosed with NHL in the study period, 2176 met the inclusion criteria. The mean age at the time of colonoscopy was 61 years. Most patients were male (61%). Overall, 1273 polyps were detected in 811 patients (37%). Sessile serrated adenomas were detected in 102 (5%) patients. The overall ADR was 12% in patients younger than 40 years of age (n = 103), 26% in patients aged 40–50 (n = 251), 34% in patients aged 51–60 (n = 630), and 43% in patients older than 60 (n = 1212). Most polyps were located in the right colon (63%), and 101 (8%) were larger than 1 cm. Villous adenomatous features were present in 1% of polyps, while high-grade dysplasia was detected in 22%. Invasive adenocarcinoma was identified in 4%. The median interval from lymphoma diagnosis to adenoma detection was 1.4 years (interquartile range 0.5–3.8 years). A repeat colonoscopy was performed in 343 patients. The overall ADR on repeat colonoscopy was 30%. Cox regression analysis revealed that age (hazards ratio 1.04; 95% confidence interval 1.03–1.05; P < 0.001) and male sex (hazards ratio 1.35; 95% confidence interval 1.13–1.60; P = 0.001) were independent factors associated with worse overall survival. By contrast, screening colonoscopy was associated with longer survival duration (hazards ratio 0.48; 95% confidence interval 0.36–0.63; P < 0.001). Conclusion: The ADR in NHL patients aged 40–50 years was equivalent to that reported in the literature in non-cancer patients aged 50–70 years. Early screening colonoscopy may be warranted in NHL patients younger than 50 years. Screening colonoscopy significantly improved the overall survival of patients with NHL.
KW - Colon adenoma
KW - Colorectal cancer
KW - Non-Hodgkin’s lymphoma
KW - Screening
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U2 - 10.1007/s10620-019-05629-z
DO - 10.1007/s10620-019-05629-z
M3 - Article
C2 - 31053975
AN - SCOPUS:85065412303
SN - 0163-2116
VL - 64
SP - 2965
EP - 2971
JO - Digestive diseases and sciences
JF - Digestive diseases and sciences
IS - 10
ER -