TY - JOUR
T1 - Prevalence of neoplasia at colonoscopy among testicular cancer survivors treated with platinum-based chemotherapy
AU - Breekveldt, Emilie C. H.
AU - Ykema, Berbel L. M.
AU - Bisseling, Tanya M.
AU - Moons, Leon M. G.
AU - Spaander, Manon C. W.
AU - Huibregtse, Inge L.
AU - van Der Biessen-van Beek, Dorien T. J.
AU - Mulder, Sasja F.
AU - Saveur, Lisette
AU - Kerst, J. Martijn
AU - Zweers, Danielle
AU - Suelmann, Britt B. M.
AU - de Wit, Ronald
AU - Reijm, Agnes
AU - van Baalen, Sophia
AU - Butterly, Lynn F.
AU - Hisey, William M.
AU - Robinson, Christina M.
AU - van Vuuren, Anneke J.
AU - Carvalho, Beatriz
AU - Lansdorp-Vogelaar, Iris
AU - Schaapveld, Michael
AU - van Leeuwen, Flora E.
AU - Snaebjornsson, Petur
AU - van Leerdam, Monique E.
N1 - Publisher Copyright:
© 2023 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.
PY - 2024/4/15
Y1 - 2024/4/15
N2 - 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 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.
AB - 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 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.
UR - http://www.scopus.com/inward/record.url?scp=85180850395&partnerID=8YFLogxK
U2 - 10.1002/ijc.34810
DO - 10.1002/ijc.34810
M3 - Article
C2 - 38151749
SN - 0020-7136
VL - 154
SP - 1474
EP - 1483
JO - International Journal of Cancer
JF - International Journal of Cancer
IS - 8
ER -
