High prevalence of advanced colorectal neoplasia and serrated polyposis syndrome in Hodgkin lymphoma survivors

• Published in: Cancer Vol. 125; no. 6; pp. 990 - 999
• Main Authors: Rigter, Lisanne S., Spaander, Manon C. W., Aleman, Berthe M. P., Bisseling, Tanya M., Moons, Leon M., Cats, Annemieke, Lugtenburg, Pieternella J., Janus, Cecile P. M., Petersen, Eefke J., Roesink, Judith M., van der Maazen, Richard W. M., Snaebjornsson, Petur, Kuipers, Ernst J., Bruno, Marco J., Dekker, Evelien, Meijer, Gerrit A., de Boer, Jan Paul, van Leeuwen, Flora E., van Leerdam, Monique E.
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 15.03.2019; John Wiley and Sons Inc
• Subjects: Abdomen; Aged; Alkylation; Cancer Survivors; Chemotherapy; Cohort Studies; Colon; Colonic Polyps - diagnosis; Colonic Polyps - epidemiology; Colonoscopy; Colorectal cancer; colorectal cancer (CRC) screening; Colorectal carcinoma; Colorectal Neoplasms - diagnosis; Colorectal Neoplasms - epidemiology; Diagnostic systems; Dysplasia; epidemiology; Female; Health risks; Hodgkin Disease - drug therapy; Hodgkin Disease - radiotherapy; Hodgkin's lymphoma; Humans; Lesions; Lymphoma; Male; Middle Aged; Oncology; Original; Polyposis; polyps/adenomas; Prevalence; Procarbazine; Procarbazine - therapeutic use; Radiation therapy; Surveillance; Tumors; polyps/adenomas; epidemiology; colorectal cancer (CRC) screening
• ISSN: 0008-543X; 1097-0142; 1097-0142
• DOI: 10.1002/cncr.31903

Background Hodgkin lymphoma (HL) survivors treated with abdominal radiotherapy and/or alkylating chemotherapy have an increased risk of colorectal cancer (CRC). This study was aimed at evaluating the prevalence of colorectal neoplasia in HL survivors. Methods This multicenter cohort study assessed the diagnostic yield of advanced colorectal neoplasia detected by a first surveillance colonoscopy among HL survivors treated with abdominal radiotherapy and/or procarbazine. Advanced colorectal neoplasia included advanced adenomas (high‐grade dysplasia, ≥25% villous component, or ≥10‐mm diameter), advanced serrated lesions (dysplasia or ≥10‐mm diameter), and CRC. The results were compared with those for a Dutch general population cohort that underwent a primary screening colonoscopy (1426 asymptomatic individuals 50‐75 years old). This study demonstrated the results of a predefined interim analysis. Results A colonoscopy was performed in 101 HL survivors, who were significantly younger (median, 51 years; interquartile range [IQR], 45‐57 years) than the general population controls (median, 60 years; IQR, 55‐65 years; P < .001). The prevalence of advanced neoplasia was higher in HL survivors than controls (25 of 101 [25%] vs 171 of 1426 [12%]; P < .001). Advanced adenomas were detected in 14 of 101 HL survivors (14%) and in 124 of 1426 controls (9%; P = .08). The prevalence of advanced serrated lesions was higher in HL survivors than controls (12 of 101 [12%] vs 55 of 1426 [4%]; P < .001). Serrated polyposis syndrome was present in 6% of HL survivors and absent in controls (P < .001). Conclusions HL survivors treated with abdominal radiotherapy and/or procarbazine have a high prevalence of advanced colorectal neoplasia. The implementation of a colonoscopy surveillance program should be considered. Hodgkin lymphoma survivors treated with abdominal radiotherapy and/or procarbazine have a high prevalence of advanced colorectal neoplasia. The implementation of a colonoscopy surveillance program should be considered.