Colonic neoplasia in asymptomatic persons with negative fecal occult blood tests

Influence of age, gender, and family history

Douglas Rex, Glen Lehman, Thomas Ulbright, J. J. Smith, D. C. Pound, R. H. Hawes, Debra Helper, M. J. Wiersema, C. D. Langefeld, W. Li

Research output: Contribution to journalArticle

294 Citations (Scopus)

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
Pages (from-to)825-831
Number of pages7
JournalAmerican Journal of Gastroenterology
Volume88
Issue number6
StatePublished - 1993

Fingerprint

Occult Blood
Hematologic Tests
Colorectal Neoplasms
Neoplasms
Adenoma
Adenomatous Polyps
Colonoscopy
Logistic Models
Regression Analysis

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Colonic neoplasia in asymptomatic persons with negative fecal occult blood tests : Influence of age, gender, and family history. / Rex, Douglas; Lehman, Glen; Ulbright, Thomas; Smith, J. J.; Pound, D. C.; Hawes, R. H.; Helper, Debra; Wiersema, M. J.; Langefeld, C. D.; Li, W.

In: American Journal of Gastroenterology, Vol. 88, No. 6, 1993, p. 825-831.

Research output: Contribution to journalArticle

@article{871d2f5ad2e64b1db98c996a92e12a25,
title = "Colonic neoplasia in asymptomatic persons with negative fecal occult blood tests: Influence of age, gender, and family history",
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.",
author = "Douglas Rex and Glen Lehman and Thomas Ulbright and Smith, {J. J.} and Pound, {D. C.} and Hawes, {R. H.} and Debra Helper and Wiersema, {M. J.} and Langefeld, {C. D.} and W. Li",
year = "1993",
language = "English",
volume = "88",
pages = "825--831",
journal = "American Journal of Gastroenterology",
issn = "0002-9270",
publisher = "Nature Publishing Group",
number = "6",

}

TY - JOUR

T1 - Colonic neoplasia in asymptomatic persons with negative fecal occult blood tests

T2 - Influence of age, gender, and family history

AU - Rex, Douglas

AU - Lehman, Glen

AU - Ulbright, Thomas

AU - Smith, J. J.

AU - Pound, D. C.

AU - Hawes, R. H.

AU - Helper, Debra

AU - Wiersema, M. J.

AU - Langefeld, C. D.

AU - Li, W.

PY - 1993

Y1 - 1993

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=0027302274&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027302274&partnerID=8YFLogxK

M3 - Article

VL - 88

SP - 825

EP - 831

JO - American Journal of Gastroenterology

JF - American Journal of Gastroenterology

SN - 0002-9270

IS - 6

ER -