Digestive Diseases and Sciences

, Volume 57, Issue 12, pp 3240–3245

Risk of Colorectal Adenomas in Women with Prior Breast Cancer

  • Ashish Shukla
  • Sandhya Shukla
  • Ayodele Osowo
  • Terry Mashtare
  • Manoop S. Bhutani
  • Sushovan Guha
Original Article

DOI: 10.1007/s10620-012-2432-9

Cite this article as:
Shukla, A., Shukla, S., Osowo, A. et al. Dig Dis Sci (2012) 57: 3240. doi:10.1007/s10620-012-2432-9
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Abstract

Background and Aims

Longer life expectancy in patients with prior breast cancer may increase their risk of developing other primary cancers, including colorectal cancer (CRC). Whether the risk of developing CRC in this patient population is higher in comparison to those with no prior cancer remains unclear. The purpose of this study was to compare the prevalence of colorectal adenomas and any CRC in breast cancer survivors with those who have no history of prior cancer and assess any difference with use of antiestrogen therapy.

Methods

We compared the prevalence of colorectal cancer and adenomas in breast cancer survivors with that of a group of matched controls. Eligible survivors were ≤85 years of age; had initially been diagnosed with stage 0, I, II, or III breast cancer; had completed all cancer treatments with the exception of adjuvant antiestrogen therapy; and had no evidence of recurrence on follow-up. We used the screening colonoscopy database at our institution to identify age-, sex-, and race-matched controls with no history of cancer.

Results

We identified 302 study-eligible breast cancer survivors and 302 matched controls. No colorectal cancers were found in either group. Forty-one breast cancer survivors and 30 controls had tubular adenomas; four survivors and three controls had villous adenoma; and eight survivors and ten controls had advanced adenoma. Multivariate regression analysis revealed that adjuvant antiestrogen therapy was not significantly associated with an increased risk of advanced adenoma.

Conclusions

The prevalence of colorectal adenomas in breast cancer survivors and controls was similar. Breast cancer survivors, including those receiving adjuvant antiestrogen therapies may follow the colorectal screening guidelines used for average-risk population.

Keywords

Breast cancer survivors Colorectal cancer Screening Colonoscopy 

Abbreviations

AA

Advanced adenoma

AT

Adjuvant therapy

BMI

Body mass index

BCS

Breast cancer survivors

CI

Confidence interval

CRC

Colorectal cancer

CRP

Colorectal Polyp

ER

Estrogen receptors

HER2

Human epidermal growth factor receptor 2

OR

Odds ratio

SIR

Standardized Incidence ratio

TA

Tubular adenoma

WHO

World Health Organization

Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  • Ashish Shukla
    • 1
  • Sandhya Shukla
    • 1
  • Ayodele Osowo
    • 2
  • Terry Mashtare
    • 1
  • Manoop S. Bhutani
    • 2
  • Sushovan Guha
    • 2
  1. 1.Department of MedicineUniversity at BuffaloBuffaloUSA
  2. 2.Division of Gastroenterology, Hepatology, and NutritionThe University of Texas Health Science Center at HoustonHoustonUSA