Impact of Screening Examinations on Survival in Familial Adenomatous Polyposis
| Autor: | I. Heiskanen, H. J. Järvinen, Tapio Luostarinen |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Adult
Male Proband congenital hereditary and neonatal diseases and abnormalities medicine.medical_specialty Adolescent Colorectal cancer medicine.medical_treatment Population Gastroenterology Familial adenomatous polyposis Internal medicine medicine Humans Mass Screening Registries education Colectomy Finland Aged education.field_of_study Relative survival business.industry Mortality rate Middle Aged medicine.disease Survival Analysis Adenomatous Polyposis Coli Life expectancy Female Colorectal Neoplasms business |
| Zdroj: | Scandinavian Journal of Gastroenterology. 35:1284-1287 |
| ISSN: | 1502-7708 0036-5521 |
| Popis: | Prophylactic family screening and surgery has improved the outcome of patients with familial adenomatous polyposis (FAP) largely preventing deaths due to colorectal cancer. The present study compared the mortality rates and causes of death of FAP patients diagnosed by symptoms (probands) or by family screening (call-up).The study comprised all 236 FAP patients registered in the Finnish Polyposis Registry until the end of June 1998. There were 116 probands and 120 call-up patients with a median age of 36.8 and 22.8 at diagnosis and median follow-up times of 6.3 and 9.9 years, respectively. Cumulative crude and relative survival estimates were calculated for each group and the causes of death were determined.The life expectancy was significantly better in the call-up group than in the probands after colectomy (P0.001). The survival rates of the call-up group equaled those expected for a comparable group in the general population up to 18 years after colectomy. The main cause of death was colorectal cancer accounting for 54 out of 68 deaths: four in the call-up group (all rectal stump cancer) and 50 in probands. Upper GI-tract cancer caused four deaths (periampullary cancer two, stomach cancer two) and two deaths were due to postoperative pulmonary embolism.The survival of FAP patients is significantly improved by prophylactic screening and surgery. Further improvement may be possible by using restorative proctocolectomy instead of colectomy and ileorectal anastomosis and by regular upper GI-tract endoscopic surveillance. |
| Databáze: | OpenAIRE |
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