August 30, 2006 (Reuters Health) - Colonic neoplasms detectedby flexible sigmoidoscopy are more prevalent in HIV-infected patientsthan in the general population, report New York City-based cliniciansin the August 14/28 issue of the Archives of Internal Medicine.

“This clinically important finding,” they write, “has substantialimplications for the estimated one million persons living with HIV inthe United States, especially since many of these individuals are nowliving well beyond 50 years of age.”

“These individuals should be offered colorectal cancer screening,”Dr. Edmund J. Bini and colleagues from New York University School ofMedicine conclude.

Among 165 HIV-infected and 2217 uninfected controls undergoingscreening sigmoidoscopy, the prevalence of adenomas or adenocarcinomasin the distal colon was 25.5% in HIV-infected patients versus 13.1% incontrol patients, a significant difference (p < 0.001).

Even after adjusting for potential confounding variables,HIV-infected patients had more than twice the risk of having a colonicneoplastic lesion (odds ratio, 2.34) than those without HIV infection.

HIV-infected patients were also more apt to have advanced neoplasia than were controls (7.3% vs 3.8%, p = 0.03), the team found.

Moreover, among subjects with positive sigmoidoscopy results,proximal colonic neoplastic lesions at follow-up colonoscopy were morecommon among patients with HIV infection after adjustment for age, sex,and race/ethnicity (odds ratio, 1.88).

“The high prevalence of colonic neoplasms in HIV patients with HIV,”Dr. Bini and colleagues conclude, “underscores the need to increaseawareness of colorectal cancer screening in this population.”



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