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Cited by 444

The DOI matches its Crossref record; 12 of the 12 references it cites were found in a registry or an index.

Duodenal adenomatosis in familial adenomatous polyposis

Open access
Bulow, S·2004·Gut

Abstract

BACKGROUND: The prevalence of duodenal carcinoma is much higher in familial adenomatous polyposis (FAP) than in the background population, and duodenal adenomatosis is found in most polyposis patients. AIMS: To describe the long term natural history of duodenal adenomatosis in FAP and evaluate if cancer prophylactic surveillance of the duodenum is indicated. METHODS: A prospective five nation study was carried out in the Nordic countries and the Netherlands. PATIENTS: A total of 368 patients were examined by gastroduodenoscopy at two year intervals during the period 1990-2001. RESULTS: At the first endoscopy, 238 (65%) patients had duodenal adenomas at a median age of 38 years. Median follow up was 7.6 years. The cumulative incidence of adenomatosis at age 70 years was 90% (95% confidence interval (CI) 79-100%), and of Spigelman stage IV 52% (95% CI 28-76%). The probability of an advanced Spigelman score increased during the study period (p<0.0001) due to an increasing number and size of adenomas. Two patients had asymptomatic duodenal carcinoma at their first endoscopy while four developed carcinoma during the study at a median age of 52 years (range 26-58). The cumulative incidence rate of cancer was 4.5% at age 57 years (95% CI 0.1-8.9%) and the risk was higher in patients with Spigelman stage IV at their first endoscopy than in those with stages 0-III (p<0.01). CONCLUSIONS: The natural course of duodenal adenomatosis has now been described in detail. The high incidence and increasing severity of duodenal adenomatosis with age justifies prophylactic examination, and a programme is presented for upper gastrointestinal endoscopic surveillance.

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Metadata

Authors
Bulow, S.
Venue
Gut
Publisher
BMJ
Published
2004-03-01
Volume
53
Issue
3
Pages
381-386
ISSN
0017-5749 (ISSN-L)
OpenAlex
W1893945215
Cited by
444
References
12
FWCI
17.33
Type
journal article
Language
en
Open access
bronze

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Bulow, S. (2004). Duodenal adenomatosis in familial adenomatous polyposis. Gut. https://doi.org/10.1136/gut.2003.027771

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