Prevalence of neoplasia at colonoscopy among testicular cancer survivors treated with platinum-based chemotherapy

Details

• Alternative Title:
  Int J Cancer
• Personal Author:
  Breekveldt, Emilie C. H. ; Ykema, Berbel L. M. ; Bisseling, Tanya M. ; Moons, Leon M. G. ; Spaander, Manon C. W. ; Huibregtse, Inge L. ; van der Biessen-van Beek, Dorien T.J. ; Mulder, Sasja F. ; Saveur, Lisette ; Kerst, J. Martijn ; Zweers, Danielle ; Suelmann, Britt B.M. ; de Wit, Ronald ; Reijm, Agnes ; van Baalen, Sophia ; Butterly, Lynn F. ; Hisey, William M. ; Robinson, Christina M. ; van Vuuren, Anneke J. ; Carvalho, Beatriz ; Lansdorp-Vogelaar, Iris ; Schaapveld, Michael ; van Leeuwen, Flora E. ; Snaebjornsson, Petur ; van Leerdam, Monique E.
• Description:
  Testicular cancer survivors (TCS) treated with platinum-based chemotherapy have an increased risk of colorectal cancer (CRC). We determined the yield of colonoscopy in TCS to assess its potential in reducing CRC incidence and mortality. We conducted a colonoscopy screening study among TCS in four Dutch hospitals to assess the yield of colorectal neoplasia. Neoplasia was defined as adenomas, serrated polyps (SPs), advanced adenomas (AAs: ≥10 mm diameter, high-grade dysplasia or ≥25% villous component), advanced serrated polyps (ASPs: ≥10 mm diameter or dysplasia) or CRC. Advanced neoplasia (AN) was defined as AA, ASP or CRC. Colonoscopy yield was compared to average-risk American males who underwent screening colonoscopy (n = 24,193) using a propensity score matched analysis, adjusted for age, smoking status, alcohol consumption and body mass index. A total of 137 TCS underwent colonoscopy. Median age was 50 years among TCS (IQR 43-57) vs 55 years (IQR 51-62) among American controls. A total of 126 TCS were matched to 602 controls. The prevalence of AN was higher in TCS than in controls (8.7% vs 1.7%; P = .0002). Nonadvanced adenomas and SPs were detected in 45.2% of TCS vs 5.5% of controls (P < .0001). No lesions were detected in 46.0% of TCS vs 92.9% of controls (P < .0001). TCS treated with platinum-based chemotherapy have a higher prevalence of neoplasia and AN than matched controls. These results support our hypothesis that platinum-based chemotherapy increases the risk of colorectal neoplasia in TCS. Cost-effectiveness studies are warranted to ascertain the threshold of AN prevalence that justifies the recommendation of colonoscopy for TCS.
• Subjects:
  Adenoma Cancer Survivors Colonic Polyps Colonoscopy Colorectal Neoplasms Humans Male Middle Aged Neoplasms, Germ Cell And Embryonal Prevalence Risk Factors Testicular Neoplasms

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• Keywords:
  Colonoscopy Screening Colorectal Cancer Platinum-based Chemotherapy Testicular Cancer Survivors
• Source:
  Int J Cancer. 154(8):1474-1483
• Pubmed ID:
  38151749
• Pubmed Central ID:
  PMC10932931
• Document Type:
  Journal Article
• Funding:
  R01 CA243449/CA/NCI NIH HHSUnited States/ ; U58 DP003930/DP/NCCDPHP CDC HHSUnited States/
• Volume:
  154
• Issue:
  8
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:51ef8589f5c9fe9e75f74f0a70c1aec7d20a6f0f290704f1ffcb8314aad1421031dff397060f1f2ae56a7bc05ad73010fb8ed4adcd035a32c25fb31a8658cd57
• Download URL:
  https://stacks.cdc.gov/view/cdc/151690/cdc_151690_DS1.pdf
• File Type:
  [PDF - 519.28 KB ]