University of Arizona College of Medicine Phoenix, AZ
Paul Gomez, MD, Kelly Zucker, DO, Sakolwan Suchartlikitwong, MD, Natasha Narang, DO, Jiali Ling, MS, Bijun S. Kannadath, MBBS, MS, Rashmi Kumar, MD; University of Arizona College of Medicine, Phoenix, AZ
Introduction: Multiple studies have suggested that rate of colon polyps and colon cancer are higher in patients with end stage liver/renal disease (ESLD/ESRD). We aimed to evaluate the incidence rate of adenomatous colon polyps on colonoscopy in ESLD/ESRD patients compared to the general population at an academic tertiary care center. Methods: Chart review performed of all adult patients who underwent a screening colonoscopy at an academic tertiary care center between March 2018 and May 2019. Demographics (age, gender, BMI, alcohol/tobacco use) and incidence of adenomatous polyps were obtained and compared between general population and ESLD/ESRD cohort. Incidence rate of polyps were analyzed using Pearson’s chi-squared test; p- value of < 0.05 was considered as significant. Results: A total of 757 patients were included in the study. 559 patients were in the general population cohort and 198 in the ESLD/ESRD cohort. ESLD/ESRD was more common in males (P=0.414). No significant demographic differences existed for age, or BMI. 209 patients (150 from general population and 59 from ESLD/ESRD) were excluded from the polyp analysis as either they did not have colonoscopy or the report was not available to review. Analysis of colonoscopy reports showed that general population had Tubular adenoma (61.86%), Tubulovillous adenoma (3.67%), Hyperplastic polyp (24.69%), Serrated polyp (5.87%) and Inflammatory polyp (4.89%). ESLD/ESRD cohort had Tubular adenoma (66.91%), Tubulovillous adenoma (5.76%), Hyperplastic polyp (22.3%), Serrated polyp (3.6%) and Inflammatory polyp (0.72%). Rates of adenomatous polyps were compared between different age groups: (40-55, 55-65, age < 50, age > 50). In the 55-65 age group the ESLD/ESRD cohort had a higher rate of tubular adenomas 73.58% compared with the general population 61.78% (P=0.089). In a subgroup analysis, ESRD patients were found to have a higher rate of tubular adenomas 81.82% compared with patients with ESLD 48% in age group 40-55 (P=0.058). Discussion: Our study shows that there is a higher incidence of tubular adenomas in ESLD/ESRD patients age 55-65 compared with the general population. Interestingly, patients with ESRD were found to have higher rates of adenomatous polyps compared with ESLD patients in age group 40-55. Though the difference is not statistically significant, we believe our study highlights the importance of further study regarding the timing of screening colonoscopy for high risk patients who are potential liver/kidney transplant candidates.
Figure 1: Rates of tubular adenomas compared between different age groups and patient populations.
Disclosures: Paul Gomez indicated no relevant financial relationships. Kelly Zucker indicated no relevant financial relationships. Sakolwan Suchartlikitwong indicated no relevant financial relationships. Natasha Narang indicated no relevant financial relationships. Jiali Ling indicated no relevant financial relationships. Bijun Kannadath indicated no relevant financial relationships. Rashmi Kumar indicated no relevant financial relationships.