Colonic Neoplasia in Asymptomatic Persons with Negative Fecal Occult Blood Tests: Influence of Age, Gender, and Family History

Douglas K. Rex, Glen A. Lehman, Thomas M. Ulbright, Jennefer J. Smith, David C. Pound, Robert H. Hawes, Debra J. Helper, Maurits J. Wiersema, Carl D. Langefeld, Wei Li

Research output: Contribution to journalArticle

297 Scopus citations

Abstract

Six hundred twenty-one asymptomatic persons with negative fecal occult blood tests (ages 50-75 yr), including 496 with no known risk factors for colorectal cancer and 125 with a single first-degree relative with a history of colonic neoplasia developed after age 40, underwent screening colonoscopy. Three Dukes A cancers were detected in average-risk persons. The overall prevalence of adenomatous polyps was 27%. Multiple logistic regression analysis revealed that increasing age and male gender were both strong predictors of colonic neoplasia (p < 0.001). A positive family history of a single first-degree relative with colorectal cancer was not associated with an increased prevalence of colonic neoplasia (p = 0.29), although an effect may be present if the relative was <60 yr at diagnosis. Overall 16% of males and 7% of women ≥60 yr had at least one adenoma that was large (≥1 cm in size), villous or tubulovillous, or had grade 3 dysplasia. We conclude that the prevalence of colonic neoplasia in asymptomatic persons with negative fecal occult blood tests is substantial, particularly in elderly males. A family history of a single first-degree relative diagnosed at age ≥60 yr with colorectal cancer is not associated with an increased prevalence of colonic adenomas.

Original languageEnglish (US)
Pages (from-to)825-831
Number of pages7
JournalThe American journal of gastroenterology
Volume88
Issue number6
DOIs
StatePublished - Jun 1993

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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