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2006 Abstracts: The prevalence of colorectal neoplasia in end stage renal disease: a case control study
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The prevalence of colorectal neoplasia in end stage renal disease: a case control study
Sharon Lee, Nir Wasserberg, Patrizio Petrone, jason Rosca, Rick Selby, Adrian Ortega, Howard kaufman; surgery, University of Southern California, Los Angeles, CA

Purpose: The scarcity of organs for transplantation has led to aggressive pretransplant evaluations. Many younger kidney transplant patients with end stage renal disease (ESRD), who would ordinarily be at average risk for colorectal cancer, undergo screening colonoscopy as part of this evaluation. The purpose of this study was to determine the prevalence of colorectal neoplasia in patients with ESRD who are potential transplant candidates. Methods: A retrospective chart review was performed of kidney transplant candidates who underwent pre-transplant screening colonoscopy at our institution from August 1999 to December 2004. Charts were assessed for clinicopathologic data including, age, gender, ethnicity, obesity, personal history of diabetes mellitus or colorectal polyps, family history of colon cancer, colonoscopic findings, and pathology results. The control group was comprised of 60 age- and gender-matched subjects without ESRD who underwent routine screening colonoscopy. Results: The study group included 58 patients (16/42 F/M), median age of 55 years (33 - 74), 16 of which were younger then 50 years old. The prevalence of polyps in ESRD patients was 36% vs 21.6% in the control group. Of patients with ESRD50 years old, 17 (40%) had polyps vs 21.9% in the control group. The prevalence of polyps in ESRD patients <50 years old was 31% vs 21% in controls. None of these differences reached statistical significance. There were no cancers detected, and none of the polyps excised and examined had high grade dysplasia. None of the risk factors studied were found to predict the presence of polyps in the study group. Diabetes (OR 13.8, 95% CI 1.73-104.9, P = 0.007), and a family history of colorectal cancer (OR 4.291, 95%CI 1.105-16.784, P = 0.034) were associated with the presence of polyps in the control group. Conclusion: The prevalence of colorectal polyps in patients with ESRD who are candidates for kidney transplantation is not statistically different than age- and gender- matched controls of otherwise similar risk. These results suggest that screening guidelines for colorectal cancer for the general population should be adequate for potential kidney transplant recipients.


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