Atrial Fibrillation: A New Indicator for Advanced Colorectal Neoplasia in Screening Colonoscopy.
atrial fibrillation
colorectal cancer
prevention
screening
Journal
Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588
Informations de publication
Date de publication:
23 Jul 2019
23 Jul 2019
Historique:
received:
21
06
2019
revised:
14
07
2019
accepted:
17
07
2019
entrez:
26
7
2019
pubmed:
26
7
2019
medline:
26
7
2019
Statut:
epublish
Résumé
Colorectal cancer (CRC) is a common and potentially preventable malignancy. Evidence has emerged that coronary artery disease patients are at increased risk for developing CRC by shared risk factors. Here we investigated an association between CRC and atrial fibrillation (AF), a surrogate marker of cardiovascular risk, in the setting of routine screening colonoscopy. We investigated 1949 asymptomatic participants (median age 61 [54-67] years, 49% females) undergoing screening colonoscopy within the SAKKOPI registry (Salzburg Colon Cancer Prevention Initiative). Forty-six participants with AF (2.4%) were identified, and colonoscopy findings were compared to non-AF participants. Propensity Score Matching (PSM) was used to create 1:1 and 3:1 age- and gender-matched couples. Abnormal findings on screening colonoscopy (any form of adenoma or carcinoma) were more common in AF participants with an odds ratios (OR) of 2.4 [1.3-4.3] in the unmatched analysis, and 2.6 [1.1-6.3] and 2.0 [1.1-4.0] in the 1:1 and 3:1 matched groups, respectively. Correspondingly, the odds of finding advanced adenomas or carcinomas was elevated about three-fold across the different matched and unmatched analyses (OR 3.3 [1.1-10.8] for 3:1 matched participants). At the same time, the prevalence and number of colonic lesions were significantly higher in AF participants (63.0% vs. 33.4% for 3:1 matched participants, Participants with AF had a higher burden of advanced premalignant adenomas and CRC in routine colonoscopy screening. Our data suggest that practitioners should monitor the CRC screening status, especially in AF patients.
Sections du résumé
BACKGROUND
BACKGROUND
Colorectal cancer (CRC) is a common and potentially preventable malignancy. Evidence has emerged that coronary artery disease patients are at increased risk for developing CRC by shared risk factors. Here we investigated an association between CRC and atrial fibrillation (AF), a surrogate marker of cardiovascular risk, in the setting of routine screening colonoscopy.
METHODS
METHODS
We investigated 1949 asymptomatic participants (median age 61 [54-67] years, 49% females) undergoing screening colonoscopy within the SAKKOPI registry (Salzburg Colon Cancer Prevention Initiative). Forty-six participants with AF (2.4%) were identified, and colonoscopy findings were compared to non-AF participants. Propensity Score Matching (PSM) was used to create 1:1 and 3:1 age- and gender-matched couples.
RESULTS
RESULTS
Abnormal findings on screening colonoscopy (any form of adenoma or carcinoma) were more common in AF participants with an odds ratios (OR) of 2.4 [1.3-4.3] in the unmatched analysis, and 2.6 [1.1-6.3] and 2.0 [1.1-4.0] in the 1:1 and 3:1 matched groups, respectively. Correspondingly, the odds of finding advanced adenomas or carcinomas was elevated about three-fold across the different matched and unmatched analyses (OR 3.3 [1.1-10.8] for 3:1 matched participants). At the same time, the prevalence and number of colonic lesions were significantly higher in AF participants (63.0% vs. 33.4% for 3:1 matched participants,
CONCLUSION
CONCLUSIONS
Participants with AF had a higher burden of advanced premalignant adenomas and CRC in routine colonoscopy screening. Our data suggest that practitioners should monitor the CRC screening status, especially in AF patients.
Identifiants
pubmed: 31340561
pii: jcm8071083
doi: 10.3390/jcm8071083
pmc: PMC6678897
pii:
doi:
Types de publication
Journal Article
Langues
eng
Références
Am J Gastroenterol. 2000 Nov;95(11):3053-63
pubmed: 11095318
Gastrointest Endosc Clin N Am. 2002 Jan;12(1):1-9, v
pubmed: 11916153
Eur Heart J. 2003 Jun;24(11):987-1003
pubmed: 12788299
JAMA. 2004 Nov 24;292(20):2471-7
pubmed: 15562125
Aliment Pharmacol Ther. 2006 Mar 15;23(6):797-805
pubmed: 16556182
Am Heart J. 2008 Dec;156(6):1163-9
pubmed: 19033014
Int J Cancer. 2009 Jul 1;125(1):171-80
pubmed: 19350627
Ann Intern Med. 2009 Jun 16;150(12):849-57, W152
pubmed: 19528563
Cancer. 2010 Feb 1;116(3):544-73
pubmed: 19998273
Dig Dis Sci. 2010 Jun;55(6):1637-42
pubmed: 20195757
Int J Cancer. 2011 Jul 1;129(1):180-91
pubmed: 20824701
Eur J Gastroenterol Hepatol. 2011 Apr;23(4):323-6
pubmed: 21389863
Intern Emerg Med. 2012 Oct;7(5):431-8
pubmed: 21968511
Dtsch Arztebl Int. 2012 Apr;109(16):293-9
pubmed: 22577476
Endoscopy. 2013;45(1):51-9
pubmed: 23212726
N Engl J Med. 2013 May 30;368(22):2113-24
pubmed: 23718166
Mayo Clin Proc. 2013 Jul;88(7):683-9
pubmed: 23751980
Circulation. 2014 Feb 25;129(8):837-47
pubmed: 24345399
J Am Coll Cardiol. 2014 Mar 18;63(10):945-53
pubmed: 24361314
Br J Cancer. 2014 Mar 4;110(5):1334-7
pubmed: 24496455
Clin Epidemiol. 2014 Jun 16;6:213-20
pubmed: 24966695
PLoS One. 2014 Aug 13;9(8):e102861
pubmed: 25119880
CA Cancer J Clin. 2015 Mar;65(2):87-108
pubmed: 25651787
J Am Coll Cardiol. 2015 May 26;65(20):2159-69
pubmed: 25792361
N Engl J Med. 2015 Aug 27;373(9):823-33
pubmed: 26095867
J Am Coll Cardiol. 2015 Sep 1;66(9):985-96
pubmed: 26113406
Nat Rev Cardiol. 2016 Apr;13(4):230-7
pubmed: 26701216
Circulation. 2016 Mar 15;133(11):1104-14
pubmed: 26976915
JAMA Cardiol. 2016 Jul 1;1(4):384-6
pubmed: 27438312
JAMA Cardiol. 2016 Jul 1;1(4):389-96
pubmed: 27438314
JAMA Cardiol. 2017 Mar 1;2(3):343-344
pubmed: 27851852
J Am Coll Cardiol. 2017 May 9;69(18):2348-2350
pubmed: 28473143
Gastroenterology. 2017 Jul;153(1):307-323
pubmed: 28600072
Eur Heart J. 2018 Apr 21;39(16):1330-1393
pubmed: 29562325
Am J Cardiol. 2018 Jun 15;121(12):1548-1551
pubmed: 29678338
Europace. 2018 Dec 1;20(12):1929-1935
pubmed: 29912366