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International Journal of Colorectal Disease

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01-01-2014 | Original Article

Chronic hepatitis C as a risk factor for colorectal adenoma

Authors: Tarun Rustagi, Emily Idel Zarookian, Omesh Qasba, Luis F. Diez

Published in: International Journal of Colorectal Disease | Issue 1/2014

Abstract

Introduction

Over the last decade, epidemiologic studies have determined a relationship between chronic hepatitis C (CHC) and malignancies other than hepatocellular carcinoma (HCC), particularly in gastrointestinal malignancies. This study aims to evaluate the incidence of colorectal adenomas and advanced neoplasia in CHC patients compared to the general population and to evaluate whether CHC infection is an independent risk factor for colorectal adenomas and advanced neoplasia.

Methods

This is a retrospective, case–control study. CHC patients who underwent screening colonoscopy between September 2006 and September 2010 were compared to randomly selected non-hepatitis C controls undergoing screening colonoscopy during the same period. Multivariate analysis was performed taking into account the known risk factors for colorectal adenoma.

Results

Two hundred thirty-three CHC patients and 466 controls that underwent screening colonoscopy were included in the study. CHC patients were younger and more likely to be male, smoker and have HIV infection compared to the control group (p < 0.05). CHC group had a significantly higher number of patients with adenomas (adenoma detection rate of 37.8 vs. 30.3 %; p = 0.04) and hyperplastic polyps (p = 0.01) detected on screening colonoscopy. The total number of adenomas detected was also higher in the CHC group; however, this was not statistically significant (0.69 vs. 0.58 per patient; p > 0.05). CHC patients were twice more likely to have advanced neoplasia detected compared to non-hepatitis C patients (odds ratio 2.04, 95 % confidence interval = 1.20–3.49; p = 0.03). CHC group was also more likely to have adenomas of ≥6 mm (p = 0.005) and macroadenomas of ≥1 cm (p = 0.02).

Limitations

Limitations include the single-center, retrospective design of the study.

Conclusions

Our study is the first to demonstrate a significantly higher rate of adenomas, advanced neoplasia, and hyperplastic polyps in CHC patients compared to the general population. On multivariate analysis, CHC infection was found to be an independent risk factor for colorectal adenoma, particularly advanced neoplasia. Larger prospective studies are needed to strengthen our findings which may have implications for colorectal cancer screening.

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Title: Chronic hepatitis C as a risk factor for colorectal adenoma
Authors: Tarun Rustagi
Emily Idel Zarookian
Omesh Qasba
Luis F. Diez
Publication date: 01-01-2014
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Colorectal Disease / Issue 1/2014
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-013-1763-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Chronic hepatitis C as a risk factor for colorectal adenoma

Abstract

Introduction

Methods

Results

Limitations

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Limitations

Conclusions

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