Abstract: SA-PO209
Risk Factors for Advanced Colorectal Neoplasia in CKD
Session Information
- Onco-Nephrology: Clinical
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Onco-Nephrology
- 1500 Onco-Nephrology
Author
- Au, Eric Hoi Kit, University of Sydney, Sydney, New South Wales, Australia
Group or Team Name
- DETECT Study Investigators
Background
Colorectal cancer is common in people with chronic kidney disease (CKD), but the risk factors are poorly understood. The aim of this study is to identify risk factors for advanced colorectal neoplasia in people with CKD (as a sub-study of DETECT).
Methods
People with CKD (stages III-V, dialysis and transplant) across eleven sites in Australia, New Zealand, Canada and Spain were screened for colorectal neoplasm using fecal immunochemical test (FIT). Advanced colorectal neoplasia was identified through a 2-step verification process with colonoscopy following a positive FIT and 2-year clinical follow-up for all patients. Potential risk factors for advanced colorectal neoplasia at different CKD stages were assessed using multivariable logistic regression.
Results
A total of 1706 patients received FIT screening (791 CKD III-V, 418 dialysis, 497 transplant). 323 (18.9%) had colonoscopy for positive FIT and 103 advanced colorectal neoplasia (44 CKD III-V, 31 dialysis, 28 transplant) were identified (overall detection rate 6%). At follow-up, 14 additional advanced neoplasia (10 CKD III-V, 3 dialysis, 1 transplant) were identified. Across CKD stages, older age and male sex were risk factors for advanced colorectal neoplasia (figure). Current smoking use was associated with advanced colorectal neoplasia among those with CKD III-V [odds ratio 2.3 (95% CI 1.1-4.9)]. For those on dialysis, patients with diabetes experienced 2.1 times greater odds of advanced colorectal neoplasia (95% CI 1.0-4.4). For kidney transplant recipients, daily anticoagulant use was associated with increased odds of advanced colorectal neoplasia [OR 4.5 (95% CI 1.5-13.4)].
Conclusion
Increasing age, smoking, male sex and having diabetes are associated with advanced colorectal neoplasia in patients with CKD. The observed increased risk associated with anticoagulation use in transplant recipients may be due to increased detection by FIT.
Funding
- Government Support - Non-U.S.