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Increased Colorectal Cancer Rate in Turner Syndrome: A Case Control Study

Received: 29 June 2021    Accepted: 12 July 2021    Published: 10 September 2021
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Abstract

Female sex hormonal supplementation had been shown to be protective against Colorectal cancer (CRC). Turner syndrome (TS) is a rare X lined chromosomal disorder associated with sex hormonal deficiency. Hence, we hypothesized that that females with TS would be at an increased risk of CRC. From the Truven Health Marketscan Commercial Claims and Encounters Database, female patients who had colonoscopy with TS were compared to aged matched to controls. For these patients we obtained demographic variables, risk factors (diabetes, morbid obesity, smoking, use of non-steroidal anti-inflammatory drugs and statins) and endoscopic results (adenoma and cancer detection) from the database. Multivariate logistic regression analysis was performed to compare the cancer detection rates in both groups. Of the 7,77,36,681 patients of age 35 or older in the database 3265 had TS. Of those 546 (17%) patients had a colonoscopy that was reported. These patients were compared to 1059 age matched controls. Prevalence of diabetes (14.3 vs 8.4, P<0.001), and smoking (2.6 vs 0.9, p=0.01) was higher in patients with TS. Cancer detection rate was higher in patients with TS (1.1% vs 0.2%, p=0.01). After adjustment for the above variables, patients with TS have an adjusted odds ratio of 9.5 for CRC at any colonoscopy (95% CI 1.7-52.8, p =0.008). Hence, we concluded that in the studied cohort of TS patients there was a higher colorectal cancer detection rate at any colonoscopy when compared to their age matched female counterparts. TS patients represent a ‘disparity group’ who warrant enhanced CRC screening.

Published in American Journal of Internal Medicine (Volume 9, Issue 5)
DOI 10.11648/j.ajim.20210905.11
Page(s) 219-224
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Colorectal Cancer, Turner Syndrome, Disparity Group, Case Control Study, Truven Marketscan Database

References
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Cite This Article
  • APA Style

    Venkata Subhash Gorrepati, Djibril M. Ba, Guodong Liu, John Levenick, Thomas McGarrity. (2021). Increased Colorectal Cancer Rate in Turner Syndrome: A Case Control Study. American Journal of Internal Medicine, 9(5), 219-224. https://doi.org/10.11648/j.ajim.20210905.11

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    ACS Style

    Venkata Subhash Gorrepati; Djibril M. Ba; Guodong Liu; John Levenick; Thomas McGarrity. Increased Colorectal Cancer Rate in Turner Syndrome: A Case Control Study. Am. J. Intern. Med. 2021, 9(5), 219-224. doi: 10.11648/j.ajim.20210905.11

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    AMA Style

    Venkata Subhash Gorrepati, Djibril M. Ba, Guodong Liu, John Levenick, Thomas McGarrity. Increased Colorectal Cancer Rate in Turner Syndrome: A Case Control Study. Am J Intern Med. 2021;9(5):219-224. doi: 10.11648/j.ajim.20210905.11

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  • @article{10.11648/j.ajim.20210905.11,
      author = {Venkata Subhash Gorrepati and Djibril M. Ba and Guodong Liu and John Levenick and Thomas McGarrity},
      title = {Increased Colorectal Cancer Rate in Turner Syndrome: A Case Control Study},
      journal = {American Journal of Internal Medicine},
      volume = {9},
      number = {5},
      pages = {219-224},
      doi = {10.11648/j.ajim.20210905.11},
      url = {https://doi.org/10.11648/j.ajim.20210905.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20210905.11},
      abstract = {Female sex hormonal supplementation had been shown to be protective against Colorectal cancer (CRC). Turner syndrome (TS) is a rare X lined chromosomal disorder associated with sex hormonal deficiency. Hence, we hypothesized that that females with TS would be at an increased risk of CRC. From the Truven Health Marketscan Commercial Claims and Encounters Database, female patients who had colonoscopy with TS were compared to aged matched to controls. For these patients we obtained demographic variables, risk factors (diabetes, morbid obesity, smoking, use of non-steroidal anti-inflammatory drugs and statins) and endoscopic results (adenoma and cancer detection) from the database. Multivariate logistic regression analysis was performed to compare the cancer detection rates in both groups. Of the 7,77,36,681 patients of age 35 or older in the database 3265 had TS. Of those 546 (17%) patients had a colonoscopy that was reported. These patients were compared to 1059 age matched controls. Prevalence of diabetes (14.3 vs 8.4, P<0.001), and smoking (2.6 vs 0.9, p=0.01) was higher in patients with TS. Cancer detection rate was higher in patients with TS (1.1% vs 0.2%, p=0.01). After adjustment for the above variables, patients with TS have an adjusted odds ratio of 9.5 for CRC at any colonoscopy (95% CI 1.7-52.8, p =0.008). Hence, we concluded that in the studied cohort of TS patients there was a higher colorectal cancer detection rate at any colonoscopy when compared to their age matched female counterparts. TS patients represent a ‘disparity group’ who warrant enhanced CRC screening.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - Increased Colorectal Cancer Rate in Turner Syndrome: A Case Control Study
    AU  - Venkata Subhash Gorrepati
    AU  - Djibril M. Ba
    AU  - Guodong Liu
    AU  - John Levenick
    AU  - Thomas McGarrity
    Y1  - 2021/09/10
    PY  - 2021
    N1  - https://doi.org/10.11648/j.ajim.20210905.11
    DO  - 10.11648/j.ajim.20210905.11
    T2  - American Journal of Internal Medicine
    JF  - American Journal of Internal Medicine
    JO  - American Journal of Internal Medicine
    SP  - 219
    EP  - 224
    PB  - Science Publishing Group
    SN  - 2330-4324
    UR  - https://doi.org/10.11648/j.ajim.20210905.11
    AB  - Female sex hormonal supplementation had been shown to be protective against Colorectal cancer (CRC). Turner syndrome (TS) is a rare X lined chromosomal disorder associated with sex hormonal deficiency. Hence, we hypothesized that that females with TS would be at an increased risk of CRC. From the Truven Health Marketscan Commercial Claims and Encounters Database, female patients who had colonoscopy with TS were compared to aged matched to controls. For these patients we obtained demographic variables, risk factors (diabetes, morbid obesity, smoking, use of non-steroidal anti-inflammatory drugs and statins) and endoscopic results (adenoma and cancer detection) from the database. Multivariate logistic regression analysis was performed to compare the cancer detection rates in both groups. Of the 7,77,36,681 patients of age 35 or older in the database 3265 had TS. Of those 546 (17%) patients had a colonoscopy that was reported. These patients were compared to 1059 age matched controls. Prevalence of diabetes (14.3 vs 8.4, P<0.001), and smoking (2.6 vs 0.9, p=0.01) was higher in patients with TS. Cancer detection rate was higher in patients with TS (1.1% vs 0.2%, p=0.01). After adjustment for the above variables, patients with TS have an adjusted odds ratio of 9.5 for CRC at any colonoscopy (95% CI 1.7-52.8, p =0.008). Hence, we concluded that in the studied cohort of TS patients there was a higher colorectal cancer detection rate at any colonoscopy when compared to their age matched female counterparts. TS patients represent a ‘disparity group’ who warrant enhanced CRC screening.
    VL  - 9
    IS  - 5
    ER  - 

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Author Information
  • Department of Gastroenterology and Hepatology, Penn State Hershey Medical Center, Hershey, USA

  • Department of Public Health Sciences, Penn State Hershey Medical Center, Hershey, USA

  • Department of Public Health Sciences, Penn State Hershey Medical Center, Hershey, USA

  • Department of Gastroenterology and Hepatology, Penn State Hershey Medical Center, Hershey, USA

  • Department of Gastroenterology and Hepatology, Penn State Hershey Medical Center, Hershey, USA

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