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Comparison of colonoscopy and fecal occult blood testing as a first-line screening of colonic lesions in patients with newly diagnosed acromegaly.

CONTENT
Patients with acromegaly have frequently colonic neoplasms; however, how acromegalic patients should be screened for colonic lesions is still unsettled.


AIMS
To compare fecal occult blood testing (FOBT) and colonoscopy in the screening program of patients with acromegaly.


DESIGN
Colonoscopy and FOBT were performed at the first diagnosis of acromegaly.


SETTING
Tertiary University center.


PATIENTS
Eighty-five consecutive patients with untreated active acromegaly submitted to colonoscopy and FOBT.


RESULTS
FOBT, which was positive in 16 (18.8%) out of 85 patients, identified 2 patients with colonic adenocarcinoma and 2 with adenoma; the remaining 12 patients had no detectable colonic lesions. Colonoscopy revealed colonic lesions in 29 patients: 3 (3.5%) cancers, 11 (12.9%) adenomas, and 15 (17.6%) hyperplastic polyps. The remaining 56 acromegalic patients had no detectable lesions. A patient with cancer and 9 patients with adenoma were missed if screened only by FOBT.


CONCLUSIONS
Colonoscopy is superior to FOBT in detecting colonic lesions at the first diagnosis of acromegaly.