Clinicopathological features and risk factors for developing colorectal neoplasia in Hodgkin’s lymphoma survivors

Berbel L.M. Ykema, Lisanne S. Rigter, Manon C.W. Spaander, Leon M.G. Moons, Tanya M. Bisseling, Berthe M.P. Aleman, Evelien Dekker, Wieke H.M. Verbeek, Ernst J. Kuipers, Jan Paul de Boer, Pieternella J. Lugtenburg, Cecile P.M. Janus, Eefke J. Petersen, Judith M. Roesink, Richard W.M. van der Maazen, Gerrit A. Meijer, Michael Schaapveld, Flora E. van Leeuwen, Beatriz Carvalho, Petur SnaebjornssonMonique E. van Leerdam*

*Corresponding author for this work

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Background: Hodgkin’s lymphoma (HL) survivors treated with abdominal radiotherapy and/or procarbazine have an increased risk of developing colorectal neoplasia. Aims: We evaluated the clinicopathological characteristics and risk factors for developing (advanced) neoplasia (AN) in HL survivors. Methods: In all, 101 HL survivors (median age 51 years, median age of HL diagnosis 25 years) underwent colonoscopy and 350 neoplasia and 44 AN (classified as advanced adenomas/serrated lesions or colorectal cancer), mostly right-sided, were detected, as published previously. An average-risk asymptomatic cohort who underwent screening colonoscopy were controls (median age 60 years). Clinicopathological characteristics of AN were evaluated in both groups. Mismatch repair (MMR) status was assessed using immunohistochemistry (MLH1/MSH2/MSH6/PMS2). Logistic regression analysis was performed to evaluate the risk factors for AN in HL survivors, including age at HL diagnosis and interval between HL and colonoscopy. Results: In 101 colonoscopies in HL survivors, AN was primarily classified based on polyp size ≥10 mm, whereas (high-grade)dysplasia was more often seen in AN in controls. An interval between HL diagnosis and colonoscopy >26 years was associated with more AN compared with an interval of <26 years, with an odds ratio for AN of 3.8 (95% confidence interval 1.4–9.1) (p < 0.01). All 39 AN that were assessed were MMR proficient. Conclusions: Colorectal neoplasia in HL survivors differ from average-risk controls; classification AN was primarily based on polyp size (≥10 mm) in HL survivors. Longer follow-up between HL diagnosis and colonoscopy was associated with a higher prevalence of AN in HL survivors.

Original languageEnglish
Pages (from-to)163-170
Number of pages8
JournalDigestive Endoscopy
Issue number1
Early online date30 Apr 2021
Publication statusPublished - Jan 2022

Bibliographical note

Funding Information:
Monique E. van Leerdam obtained funding from the Dutch Digestive Disease Foundation (Maag Lever Darm Stichting) through funding project FP 14‐04. The Dutch Digestive Disease Foundation had no role in the study design or in the collection, analysis, and interpretation of data.

Funding Information:
We acknowledge the NKI- AVL Core Facility Molecular Pathology & Biobanking (CFMPB) for supplying NKI-AVL Biobank material and lab support.

Publisher Copyright:
© 2021 The Authors. Digestive Endoscopy published by John Wiley & Sons Australia, Ltd on behalf of Japan Gastroenterological Endoscopy Society


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