Prevalence of neoplasia at colonoscopy among testicular cancer survivors treated with platinum-based chemotherapy
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
(2024) International Journal of Cancer, volume 154, issue 8, pp. 1474 - 1483
(Article)
Abstract
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
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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.
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Keywords: colonoscopy screening, colorectal cancer, platinum-based chemotherapy, testicular cancer survivors, Oncology, Cancer Research, Journal Article
ISSN: 0020-7136
Publisher: Wiley-Liss Inc.
Note: Publisher Copyright: © 2023 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.
(Peer reviewed)