Prevalence of adenomas and hyperplastic polyps in mismatch repair mutation carriers among CAPP2 participants: Report by the colorectal adenoma/carcinoma prevention programme 2

Annelie Liljegren, Gail Barker, Faye Elliott, Lucio Bertario, Marie Luise Bisgaard, Diana Eccles, Gareth Evans, Finlay Macrae, Eamonn Maher, Annika Lindblom, Samuel Rotstein, Bo Nilsson, Jukka Pekka Mecklin, Gabriela Möslein, Jeremy Jass, Riccardo Fodde, John Mathers, John Burn, D. Timothy Bishop

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To determine the prevalence of adenomatous and hyperplastic polyps in a large cohort of individuals with a germline mutation in a mismatch repair (MMR) gene, the major genetic determinant of hereditary nonpolyposis colorectal cancer (HNPCC). These prevalences have been estimated previously in smaller studies, and the results have been found to be variable. Patients and Methods: Colorectal Adenoma/Carcinoma Prevention Programme 2 trial is a chemoprevention trial in people classified as having HNPCC. The 695 patients with a proven germline MMR mutation and documented screening history before the chemoprevention study were the focus of this study. The number, histology, size, and location of polyps found at the participants' first ever colonoscopy were analyzed in a cross-sectional study. Results: Seventy-four patients (10.6%) were found to have at least one adenoma at first colonoscopy, whereas 37 (5.3%) had at least one hyperplastic polyp. The frequency of an adenoma at first colonoscopy increased from 5.0% (95% CI, 2.8% to 8.3%) in patients younger than 35 years old to 18.9% (95% CI, 9.4% to 32.0%) in patients age at least 55 years (P = .0001 for trend). No such trend was observed for hyperplastic polyps. No sex differences were found for either type of polyp. A marginal association was found between the co-occurrence of adenomas and hyperplastic polyps. Adenomas tended to be more proximally distributed through the colon, whereas hyperplastic polyps tended to be located in the distal colon. Conclusion: Adenoma prevalence increases with age among MMR mutation carriers, whereas hyperplastic polyp prevalence is consistent. No sex differences were observed for either type of lesion.

Original languageEnglish
Pages (from-to)3434-3439
Number of pages6
JournalJournal of Clinical Oncology
Volume26
Issue number20
DOIs
Publication statusPublished - 2008

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

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