| Repeated colonoscopic screening of patients with acromegaly: 15-year experience identifies those at risk of new colonic neoplasia and allows for effective screening guidelines. | |
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MedLine Citation:
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PMID: 20435617 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: It is suggested that patients with acromegaly have an increased risk of colorectal cancer and pre-malignant adenomatous polyps. However, the optimum frequency with which colonoscopic screening should be offered remains unclear. DESIGN: To determine the optimum frequency for repeated colonoscopic surveillance of acromegalic patients. METHODS: We retrospectively reviewed the case records of all patients with acromegaly seen in our centre since 1992: 254 patients had at least one surveillance colonoscopy, 156 patients had a second surveillance colonoscopy, 60 patients had a third surveillance colonoscopy and 15 patients had a fourth surveillance colonoscopy. RESULTS: The presence of hyperplastic or adenomatous polyps was assessed in all patients, while one cancer was detected at the second surveillance. At the third surveillance, mean (+/-s.d.) serum IGF1 levels (ng/ml) in patients with hyperplastic polyps were significantly higher than those with normal colons (P<0.05). The presence of an adenoma rather than a normal colon at the first colonoscopy was associated with a significantly increased risk of adenoma at the second (odds ratio (OR) 4.4, 95% confidence interval (CI) 1.9-10.4) and at the third (OR 8.8, 95% CI 2.9-26.5) screens. Conversely, a normal colon at the first surveillance gave a high chance of normal findings at the second (78%) or third surveillance (78%), and a normal colon at the second colonoscopy was associated with normality at the third colonoscopy (81%). CONCLUSIONS: Repeated colonoscopic screening of patients with acromegaly demonstrated a high prevalence of new adenomatous and hyperplastic colonic polyps, dependent on both the occurrence of previous polyps and elevated IGF1 levels. |
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Authors:
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D Dworakowska; M Gueorguiev; P Kelly; J P Monson; G M Besser; S L Chew; S A Akker; W M Drake; P D Fairclough; A B Grossman; P J Jenkins |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-04-30 |
Journal Detail:
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Title: European journal of endocrinology / European Federation of Endocrine Societies Volume: 163 ISSN: 1479-683X ISO Abbreviation: Eur. J. Endocrinol. Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-06-24 Completed Date: 2010-07-02 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9423848 Medline TA: Eur J Endocrinol Country: England |
Other Details:
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Languages: eng Pagination: 21-8 Citation Subset: IM |
Affiliation:
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Department of Endocrinology, Barts and The London School of Medicine, 68 Harley Street, London EC1A 7BE, UK. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acromegaly
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complications,
diagnosis* Adenomatous Polyps / etiology Aged Colon / pathology Colonic Neoplasms / etiology* Colonoscopy* Human Growth Hormone / blood Humans Insulin-Like Growth Factor I / metabolism Male Middle Aged Radioimmunoassay |
| Chemical | |
Reg. No./Substance:
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12629-01-5/Human Growth Hormone; 67763-96-6/Insulin-Like Growth Factor I |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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