A MULTICENTER, MULTIYEAR, CASE-CONTROLLED STUDY OF THE RISK OF COLONIC POLYPS IN PATIENTS WITH GASTRIC POLYPS - ARE GASTRIC ADENOMAS A NEW INDICATION FOR SURVEILLANCE COLONOSCOPY

A multicenter, multiyear, case-controlled colonoscopic study of 41 pat ients with gastric polyps undergoing colonoscopy analyzed whether pati ents with gastric polyps, particularly adenomas, run an increased risk of having colonic polyps. The primary controls were 109 patients unde rgoing colonoscopy matched for age and colonoscopy indications. A seco ndary control group was 69 of these 109 patients who, in addition to m atching for age and colonoscopy indications with study patients, had n o gastric polyps demonstrated by upper gastrointestinal examination. P atients with nonmalignant mucosal gastric polyps had a significantly g reater incidence than primary controls of colonic polyps [odds ratio ( OR) = 3.19, OR confidence interval = 1.46 - 6.99, p < 0.004, chi(2)], colonic neoplasms (OR = 3.58, OR confidence interval = 1.56 - 8.23, p < 0.006, chi(2)), and colonic cancer (OR = 4.5, OR confidence interval = 1.05 - 19.4, p < 0.04, Fisher's exact test). Moreover, patients wit h gastric adenomas had a significantly greater incidence than did prim ary controls of colonic polyps (OR = 7.6, OR confidence interval = 1.2 9 - 44.7, p < 0.02, Fisher's exact test). The association between gast ric and colonic polyps did not arise as an artifact of the significant ly higher frequency of females in the study group because this associa tion remained after patient stratification by sex. The higher risk of colonic polyps in study patients did not arise as an artifact of unapp reciated gastric polyps in the primary controls because study patients also had a significantly higher risk of colonic polyps than the secon dary controls (OR = 3.21, OR confidence interval = 1.35 - 7.63, p < 0. 01, chi(2)). Our retrospective case-controlled study suggests that gas tric adenomas may be a new, significant risk factor for colonic polyps . A strong association would require that patients with gastric adenom as undergo surveillance colonoscopy to diagnose and remove colonic pol yps. However, before we apply this finding to clinical practice, the a pparent association should be confirmed by another, preferably prospec tive, study.