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Prevalence of Colorectal Polyps in Pediatric Colonoscopy

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Abstract

Background

The available data regarding the prevalence, types, and clinical determinants of colonic polyps in children is limited.

Aims

We aimed to estimate the prevalence of colorectal polyps in a large cohort of children.

Methods

We conducted a cross-sectional study to determine the presence, number, and location of colorectal polyps reported in all children (0–20 years) who underwent colonoscopy at 14 pediatric facilities between January 2000 and December 2007 recorded in Pediatric Endoscopy Database System Clinical Outcomes Research Initiative (PEDS-CORI). We compared procedures with and without polyps with respect to procedure indication, age, sex, and race. We also reviewed a sample of histopathologic reports from one participating center.

Results

We analyzed 13,115 colonoscopy procedures performed in 11,637 patients. Colorectal polyps were reported in 810 procedures (6.1%; 95% CI: 5.7–6.5%) performed in 705 patients, and in 12% of patients with lower GI bleeding. Children with colorectal polyps were significantly younger (8.9 years vs. 11.9 years; p < 0.0001), male (58.3% vs. 49.0%; p < 0.001), non-white race (27.5% vs. 21.9%; p < 0.001), and had lower GI bleeding (54.4% vs. 26.6%; p < 0.001) as compared to children without polyps. In a sample of 122 patients with polyps from a single center, the histological types were solitary juvenile in 91 (70.5%), multiple juvenile in 20 (15.5%), adenoma in 14 (10.9%) and hyperplastic polyps in four patients (3.1%).

Conclusions

Colorectal polyps are detected in 6.1% overall and in 12.0% among those with lower gastrointestinal bleeding during pediatric colonoscopy. Approximately 26% are multiple juvenile or adenoma.

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References

  1. Hyer W, Beveridge I, Domizio P, et al. Clinical management and genetics of gastrointestinal polyps in children. J Pediatr Gastroenterol Nutr. 2000;31:469–479.

    Article  PubMed  CAS  Google Scholar 

  2. Thakkar K, El-Serag HB, Mattek N, et al. Complications of pediatric colonoscopy: a five-year multicenter experience. Clin Gastroenterol Hepatol. 2008;6:515–520.

    Article  PubMed  Google Scholar 

  3. Gupta SK, Fitzgerald JF, Croffie JM, et al. Experience with juvenile polyps in North American children: the need for pancolonoscopy. Am J Gastroenterol. 2001;96:1695–1697.

    Article  PubMed  CAS  Google Scholar 

  4. Mougenot JF, Baldassarre ME, Mashako LM, et al. Recto-colic polyps in the child. Analysis of 183 cases. Arch Fr Pediatr. 1989;46:245–248.

    PubMed  CAS  Google Scholar 

  5. Latt TT, Nicholl R, Domizio P, et al. Rectal bleeding and polyps. Arch Dis Child. 1993;69:144–147.

    Article  PubMed  CAS  Google Scholar 

  6. Gilger MA, Gold BD. Pediatric endoscopy: new information from the PEDS-CORI project. Curr Gastroenterol Rep. 2005;7:234–239.

    Article  PubMed  Google Scholar 

  7. Sandler RS. Epidemiology and risk factors for colorectal cancer. Gastroenterol Clin North Am. 1996;25:717–735.

    Article  PubMed  CAS  Google Scholar 

  8. Lieberman DA, Holub JL, Moravec MD, et al. Prevalence of colon polyps detected by colonoscopy screening in asymptomatic black and white patients. JAMA. 2008;300:1417–1422.

    Article  PubMed  CAS  Google Scholar 

  9. Morimoto LM, Newcomb PA, Ulrich CM, et al. Risk factors for hyperplastic and adenomatous polyps: evidence for malignant potential? Cancer Epidemiol Biomarkers Prev. 2002;11:1012–1018.

    PubMed  Google Scholar 

  10. Kanna B, Schori M, Azeez S, et al. Colorectal tumors within an urban minority population in New York City. J Gen Intern Med. 2007;22:835–840.

    Article  PubMed  Google Scholar 

  11. Poddar U, Thapa BR, Vaiphei K, et al. Colonic polyps: experience of 236 Indian children. Am J Gastroenterol. 1998;93:619–622.

    Article  PubMed  CAS  Google Scholar 

  12. Muto T, Bussey HJ, Morson BC. The evolution of cancer of the colon and rectum. Cancer. 1975;36:2251–2270.

    Article  PubMed  CAS  Google Scholar 

  13. Hoffenberg EJ, Sauaia A, Maltzman T, et al. Symptomatic colonic polyps in childhood: not so benign. J Pediatr Gastroenterol Nutr. 1999;28:175–181.

    Article  PubMed  CAS  Google Scholar 

  14. Mandhan P. Sigmoidoscopy in children with chronic lower gastrointestinal bleeding. J Paediatr Child Health. 2004;40:365–368.

    Article  PubMed  CAS  Google Scholar 

  15. Cynamon HA, Milov DE, Andres JM. Diagnosis and management of colonic polyps in children. J Pediatr. 1989;114:593–596.

    Article  PubMed  CAS  Google Scholar 

  16. Williams AR, Balasooriya BA, Day DW. Polyps and cancer of the large bowel: a necropsy study in Liverpool. Gut. 1982;23:835–842.

    Article  PubMed  CAS  Google Scholar 

  17. Jass JR. Hyperplastic polyps and colorectal cancer: is there a link? Clin Gastroenterol Hepatol. 2004;2:1–8.

    Article  PubMed  Google Scholar 

  18. Huang EH, Whelan RL, Gleason NR, et al. Increased incidence of colorectal adenomas in follow-up evaluation of patients with newly diagnosed hyperplastic polyps. Surg Endosc. 2001;15:646–648.

    Article  PubMed  CAS  Google Scholar 

  19. Croizet O, Moreau J, Arany Y, et al. Follow-up of patients with hyperplastic polyps of the large bowel. Gastrointest Endosc. 1997;46:119–123.

    Article  PubMed  CAS  Google Scholar 

  20. Liljegren A, Lindblom A, Rotstein S, et al. Prevalence and incidence of hyperplastic polyps and adenomas in familial colorectal cancer: correlation between the two types of colon polyps. Gut. 2003;52:1140–1147.

    Article  PubMed  CAS  Google Scholar 

  21. Kapetanakis AM, Vini D, Plitsis G. Solitary juvenile polyps in children and colon cancer. Hepatogastroenterology. 1996;43:1530–1531.

    PubMed  CAS  Google Scholar 

  22. Giardiello FM, Hamilton SR, Kern SE, et al. Colorectal neoplasia in juvenile polyposis or juvenile polyps. Arch Dis Child. 1991;66:971–975.

    Article  PubMed  CAS  Google Scholar 

  23. Jass JR, Williams CB, Bussey HJ, et al. Juvenile polyposis—a precancerous condition. Histopathology. 1988;13:619–630.

    Article  PubMed  CAS  Google Scholar 

  24. Schreibman IR, Baker M, Amos C, et al. The hamartomatous polyposis syndromes: a clinical and molecular review. Am J Gastroenterol. 2005;100:476–490.

    Article  PubMed  Google Scholar 

  25. Gryboski JD. All juvenile polyps are not benign. Am J Gastroenterol. 1986;81:397.

    PubMed  CAS  Google Scholar 

  26. Liu TH, Chen MC, Tseng HC, et al. Malignant change of juvenile polyp of colon: a case report. Chin Med J (Engl). 1978;4:434–439.

    CAS  Google Scholar 

  27. Mestre JR. The changing pattern of juvenile polyps. Am J Gastroenterol. 1986;81:312–314.

    PubMed  CAS  Google Scholar 

  28. Fox VL, Perros S, Jiang H, et al. Juvenile polyps: recurrence in patients with multiple and solitary polyps. Clin Gastroenterol Hepatol. 2010;8:795–799.

    Article  PubMed  Google Scholar 

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Acknowledgments

The study was supported with funding from NIDDK U01DK57132. In addition, the practice network (Clinical Outcomes Research Initiative) has received support from the following entities to support the infrastructure of the practice-based network: AstraZeneca, Novartis, Bard International, Pentax USA, ProVation, Endosoft, GIVEN Imaging, and Ethicon. The commercial entities had no involvement in this research.

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Authors and Affiliations

  1. The Section of Pediatric Gastroenterology, Hepatology and Nutrition, Texas Children’s Hospital and Baylor College of Medicine, 6621 Fannin St CCC 1010, Houston, TX, 77030, USA

    Kalpesh Thakkar & Mark A. Gilger

  2. The Sections of Gastroenterology and Health Services Research, The Houston Veterans Affairs Medical Center and the Department of Medicine at Baylor College of Medicine, Houston, TX, USA

    Abeer Alsarraj & Hashem B. El Serag

  3. Baylor University, Waco, TX, USA

    Emily Fong

  4. Department of Gastroenterology, Oregon Health and Science University, Portland, OR, USA

    Jennifer L. Holub

Authors
  1. Kalpesh Thakkar
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  2. Abeer Alsarraj
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  3. Emily Fong
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  4. Jennifer L. Holub
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  5. Mark A. Gilger
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  6. Hashem B. El Serag
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Correspondence to Kalpesh Thakkar.

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Thakkar, K., Alsarraj, A., Fong, E. et al. Prevalence of Colorectal Polyps in Pediatric Colonoscopy. Dig Dis Sci 57, 1050–1055 (2012). https://doi.org/10.1007/s10620-011-1972-8

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  • DOI: https://doi.org/10.1007/s10620-011-1972-8

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