Faculty and Assitant DIO Penn State Hershey Medical Center Hummelstown, PA
Venkata Subhash Gorrepati, MD, MPH1, John M. Levenick, MD2, Djibril Ba, MPH3, Guodong Liu, PhD2, Thomas McGarrity, MD4; 1Penn State Hershey Medical Center, Hummelstown, PA; 2Penn State University Milton S. Hershey Medical Center and College of Medicine, Hershey, PA; 3Penn State College of Medicine, Hershey, PA; 4MS Hershey Medical Center, Hershey, PA
Introduction: Colorectal cancer (CRC) is a common cancer and a major cause of cancer related deaths within the United states. Female sex hormonal supplementation had been shown to be protective against CRC. Turner syndrome (TS) is a rare X lined chromosomal disorder and results in gonadal agenesis. Hence, we hypothesized that that females with TS would be at an increased risk of being detected with CRC when compared to their age matched controls during colonoscopy. Methods: We undertook this study using Truven Health Marketscan Commercial Claims and Encounters Database. Of the patients who had colonoscopy, females with TS cases were defined as cases and were aged matched to controls (without TS) in a 1: N fashion. For these patients we obtained demographic variables, risk factors (diabetes, morbid obesity, smoking, use of non-steroidal anti-inflammatory drugs and statins) and endoscopic results (adenoma and cancer detection) from the database. Multivariate logistic regression analysis was performed to compare the cancer detection rates in both groups using SAS version 9.4. Results: Of the 7,77,36,681 patients of age 35 or older in the database 3265 had TS. Of those 546(17%) patients had a colonoscopy that was reported. These patients were compared to 1059 age matched controls. Prevalence of diabetes (14.3 vs 8.4, P< 0.001), and smoking (2.6 vs 0.9, p=0.01) was higher in patients with TS. There was no difference in the prevalence of obesity, use of statins, use of NSAIDs and adenoma detection rates between the groups. Cancer detection rate was higher in patients with TS than those without TS (1.1% vs 0.2%, p=0.01). After adjustment for the available variables that influence CRC, patients with TS have an adjusted odds ratio of 9.5 for CRC at any colonoscopy (95% CI 1.7-52.8, p =0.008). Discussion: In the studied cohort of TS patients there was a higher colorectal cancer detection rate at any colonoscopy when compared to their age matched female counterparts. Thus TS patients represent a ‘disparity group’ who warrant enhanced CRC screening.
Table 1: Demographic table
Table 2: Multivariate regression model for odds of having CRC
Disclosures: Venkata Subhash Gorrepati indicated no relevant financial relationships. John Levenick indicated no relevant financial relationships. Djibril Ba indicated no relevant financial relationships. Guodong Liu indicated no relevant financial relationships. Thomas McGarrity indicated no relevant financial relationships.