August 30, 2006

Colonic Neoplasms Prevalent in People With HIV
(Reuters Health)

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

"This clinically important finding," they write, "has substantial implications for the estimated one million persons living with HIV in the United States, especially since many of these individuals are now living 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 of Medicine conclude.

Among 165 HIV-infected and 2217 uninfected controls undergoing screening sigmoidoscopy, the prevalence of adenomas or adenocarcinomas in the distal colon was 25.5% in HIV-infected patients versus 13.1% in control 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 colonic neoplastic 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 more common 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 increase awareness of colorectal cancer screening in this population."



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