Al Hadad Mohammed, Dehni Nidal, Alakhras Abdullah, Ziaei Yalda, Turrin Nicolas P, Nimeri Abdelrahman
Division of General, Thoracic, and Vascular Surgery, Sheikh Khalifa Medical City Managed by Cleveland Clinic, Abu Dhabi, UAE.
Surg Endosc. 2014 May;28(5):1607-12. doi: 10.1007/s00464-013-3358-9. Epub 2014 Jan 8.
Cancer is one of the most common causes of death among morbidly obese individuals. Obese individuals have a well-documented increased risk of colon cancer. No guidelines are available for the workup of bariatric surgery patients in relation to colon cancer.
The indications for screening colonoscopy at the Bariatric and Metabolic Institute Abu Dhabi (BMI Abu Dhabi) include all patients older than 50 years [40 years if patients are United Arab Emirates (UAE) nationals] with unexplained abdominal symptoms, anemia of unknown cause, or a family or personal history of colonic pathology. This study retrospectively reviewed the charts of all the patients who had colonoscopy during the period January 2009 to January 2013. The patients were divided into two groups: group A [patients with a body mass index (BMI) > 30 kg/m(2)] and group B (patients with a BMI < 30 kg/m(2)). The demographics and the prevalence of polyps and cancer in the two groups were compared.
During the study period, 341 colonoscopies were performed: 137 for patients with a BMI higher than 30 kg/m(2) (mean age, 44 years) and 204 for patients with a BMI lower than 30 kg/m(2) (mean age, 46 years) (P > 0.05). The overall prevalence of adenomatous polyps was 6.74 % and that of cancer was 1.75 %. Further analysis showed that the prevalences of adenomatous polyps and cancer were respectively 12.4 and 2.1 % for the patients with a BMI higher than 30 kg/m(2), whereas the prevalences were respectively 2.9 and 0.9 % for the patients with BMI lower than 30 kg/m(2) (P < 0.001).
The risk for the development of colonic adenomatous polyps and cancer is high among young obese individuals in the Middle East. Guidelines are needed to establish criteria for screening in this group of individuals.
癌症是病态肥胖个体中最常见的死亡原因之一。肥胖个体患结肠癌的风险增加，这一点已有充分记录。目前尚无针对肥胖症手术患者结肠癌检查的指南。
阿布扎比肥胖与代谢研究所（BMI阿布扎比）进行结肠镜筛查的指征包括所有年龄超过50岁（如果是阿联酋国民则为40岁）且有不明原因腹部症状、不明原因贫血或有结肠病理家族史或个人史的患者。本研究回顾性分析了2009年1月至2013年1月期间所有接受结肠镜检查患者的病历。患者分为两组：A组[体重指数（BMI）>30 kg/m²的患者]和B组（BMI<30 kg/m²的患者）。比较两组的人口统计学特征以及息肉和癌症的患病率。
在研究期间，共进行了341例结肠镜检查：BMI高于30 kg/m²的患者137例（平均年龄44岁），BMI低于30 kg/m²的患者204例（平均年龄46岁）（P>0.05）。腺瘤性息肉的总体患病率为6.74%，癌症患病率为1.75%。进一步分析显示，BMI高于30 kg/m²的患者腺瘤性息肉和癌症的患病率分别为12.4%和2.1%，而BMI低于30 kg/m²的患者患病率分别为2.9%和0.9%（P<0.001）。
中东地区年轻肥胖个体发生结肠腺瘤性息肉和癌症的风险较高。需要制定指南来确立该群体的筛查标准。
