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Accelerated Premalignant Polyposis and Second Colon Cancers: Incriminating Immunosuppression, Radiotherapy, and Systemic Chemotherapy Agents

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Abstract

Background

Cancer survivors are known to be at increased risk for second primary cancers. In addition, immunosuppression and previous cancer treatments such as radiotherapy and systemic chemotherapy are linked with increased risk of both colonic adenomas and adenocarcinomas.

Aim

We performed a systematic review searching for manuscripts discussing second colon cancers, accelerated polyposis, immunosuppression, radiation, and chemotherapy. We sought to identify a link between immunosuppression and increased risks specific to premalignant polyposis and second colon cancers.

Findings

We identified multiple studies demonstrating associations between radiotherapy, systemic chemotherapy, and immunosuppression with a higher propensity for second colon adenomas and adenocarcinomas. When compared to the general population, these risks were more profound and the rate at which these second malignancies developed was significantly increased.

Conclusions

We believe that timing for colonoscopic surveillance in these patients should be different from the general population in order to identify promptly these rapidly progressive neoplasms. Screening for second malignancies should be considered early after remission of the primary cancer is documented, especially when a prolonged survival or a cure is anticipated. We also recommend consideration be given to increasing the frequency of colonoscopy in these cohorts. Future studies are required in order to establish the optimal time interval for surveillance colonoscopy in these high-risk individuals.

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Authors and Affiliations

  1. Department of Medicine, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT, 06030, USA

    Frank J. Senatore & Shruti Murali

  2. Lucy Curci Cancer Center, Eisenhower Medical Center/University of Southern California, Rancho Mirage, CA, USA

    Constantin A. Dasanu

Authors
  1. Frank J. Senatore
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  2. Shruti Murali
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  3. Constantin A. Dasanu
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Corresponding author

Correspondence to Frank J. Senatore.

Ethics declarations

We certify that we do not have any affiliation with or financial involvement in any organization or entity with a direct financial interest in the subject matter or materials discussed in the manuscript (e.g., employment, consultancies, stock ownership, honoraria, and expert testimony). We do not have any commercial or proprietary interest in any drug, device, or equipment mentioned in the article below. No financial support was used for this work. No previously published figures or tables were used in this paper. We certify sufficient participation of each author in the conception, design, analysis, interpretation, writing, revising, and approval of the manuscript.

Conflict of Interest

The authors declare that they have no conflict of interest.

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Senatore, F.J., Murali, S. & Dasanu, C.A. Accelerated Premalignant Polyposis and Second Colon Cancers: Incriminating Immunosuppression, Radiotherapy, and Systemic Chemotherapy Agents. J Gastrointest Canc 47, 152–156 (2016). https://doi.org/10.1007/s12029-016-9813-9

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  • DOI: https://doi.org/10.1007/s12029-016-9813-9

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