Patients with Non-Hodgkin’s Lymphoma Are at Risk of Adenomatous Colon Polyps
Patients with non-Hodgkin’s lymphoma (NHL) are frequently referred for colonoscopy to evaluate gastrointestinal symptoms during their treatment course. Here, we described the rate of colonic adenomas in patients with NHL.
This was a retrospective study of patients with NHL who underwent colonoscopy after being diagnosed with NHL between January 2000 and December 2017.
Of the 17,938 patients who had been diagnosed with NHL in the study period, 2176 met the inclusion criteria. The mean age at the time of colonoscopy was 61 years. Most patients were male (61%). Overall, 1273 polyps were detected in 811 patients (37%). Sessile serrated adenomas were detected in 102 (5%) patients. The overall ADR was 12% in patients younger than 40 years of age (n = 103), 26% in patients aged 40–50 (n = 251), 34% in patients aged 51–60 (n = 630), and 43% in patients older than 60 (n = 1212). Most polyps were located in the right colon (63%), and 101 (8%) were larger than 1 cm. Villous adenomatous features were present in 1% of polyps, while high-grade dysplasia was detected in 22%. Invasive adenocarcinoma was identified in 4%. The median interval from lymphoma diagnosis to adenoma detection was 1.4 years (interquartile range 0.5–3.8 years). A repeat colonoscopy was performed in 343 patients. The overall ADR on repeat colonoscopy was 30%. Cox regression analysis revealed that age (hazards ratio 1.04; 95% confidence interval 1.03–1.05; P < 0.001) and male sex (hazards ratio 1.35; 95% confidence interval 1.13–1.60; P = 0.001) were independent factors associated with worse overall survival. By contrast, screening colonoscopy was associated with longer survival duration (hazards ratio 0.48; 95% confidence interval 0.36–0.63; P < 0.001).
The ADR in NHL patients aged 40–50 years was equivalent to that reported in the literature in non-cancer patients aged 50–70 years. Early screening colonoscopy may be warranted in NHL patients younger than 50 years. Screening colonoscopy significantly improved the overall survival of patients with NHL.
KeywordsNon-Hodgkin’s lymphoma Colon adenoma Colorectal cancer Screening
Adenoma detection rate
Medical editing of this paper was provided by the Department of Scientific Publications at MD Anderson Cancer Center.
YW was the senior author of this study, developed the concept, designed the study, interpreted the results, ensured that the accuracy and integrity of the data was preserved at all stages, agreed to be accountable for all aspects of this study, was in charge of the overall direction and planning of the study, and contributed to the writing of the manuscript with input from all authors. HA collected the data for the study, assessed to conduct and interpret the analysis, and wrote the manuscript. EC and NM assessed in writing and editing the paper and collecting data from patients’ medical charts. WQ and PL processed the data, performed the statistical analysis, and designed the figures. OA, HJL, RB, LSW, BW, and GSR revised critically the final version of the manuscript. All authors read and approved the final manuscript.
Compliance with ethical standards
Conflict of interest
The authors have declared no conflicts of interest.
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