Abstract
Objective Patients with cystic fibrosis (pwCF) have a high incidence of early colorectal cancer (CRC). In the absence of a UK CRC screening programme for pwCF, we evaluated the utility and outcomes of colonoscopy and CRC at a large UK CF centre.
Design In a retrospective study of colonoscopy and CRC outcomes between 2010 and 2020 in pwCF aged≥30 years at a large CF centre, data were collected on colonoscopy indications and findings, polyp detection rates, bowel preparation regimens and outcomes, colonoscopy completion rates, and patient outcomes.
Results We identified 361 pwCF aged ≥30 years, of whom 135 were ≥40 years old. In the absence of a UK CRC screening guideline only 33 (9%)/361 pwCF aged ≥30 years (mean age: 44.8±11.0 years) had a colonoscopy between 2010 and 2020. Colonoscopy completion rate was 94.9%, with a 33% polyp detection rate, 93.8% of the polyps retrieved were premalignant. During the study period no patients developed postcolonoscopy CRC. However, of the patients aged ≥40 years who did not have a colonoscopy (111/135, 82.2%), four (3.6%) patients developed CRC and three pwCF died from complications of CRC.
Conclusion In this 10-year experience from a large CF centre, colonoscopy uptake for symptomatic indications was low, yet of high yield for premalignant lesions in pwCF >40 years. These data highlight the risk of potentially preventable, early CRC, and therefore support the need for prospective, large-scale nationwide studies which may inform the need for UK CRC screening guidelines for pwCF.
Design In a retrospective study of colonoscopy and CRC outcomes between 2010 and 2020 in pwCF aged≥30 years at a large CF centre, data were collected on colonoscopy indications and findings, polyp detection rates, bowel preparation regimens and outcomes, colonoscopy completion rates, and patient outcomes.
Results We identified 361 pwCF aged ≥30 years, of whom 135 were ≥40 years old. In the absence of a UK CRC screening guideline only 33 (9%)/361 pwCF aged ≥30 years (mean age: 44.8±11.0 years) had a colonoscopy between 2010 and 2020. Colonoscopy completion rate was 94.9%, with a 33% polyp detection rate, 93.8% of the polyps retrieved were premalignant. During the study period no patients developed postcolonoscopy CRC. However, of the patients aged ≥40 years who did not have a colonoscopy (111/135, 82.2%), four (3.6%) patients developed CRC and three pwCF died from complications of CRC.
Conclusion In this 10-year experience from a large CF centre, colonoscopy uptake for symptomatic indications was low, yet of high yield for premalignant lesions in pwCF >40 years. These data highlight the risk of potentially preventable, early CRC, and therefore support the need for prospective, large-scale nationwide studies which may inform the need for UK CRC screening guidelines for pwCF.
| Original language | English |
|---|---|
| Pages | e001178 |
| Publication status | Published - 31 Jul 2023 |
