[Frequency of duodenal adenomas in patients with familial adenomatous polyposis]. / Frequentie van duodenumadenomen bij patiënten met familiaire adenomateuze polyposis.

ABSTRACT

OBJECTIVE: To estimate the prevalence of polyps in the stomach and duodenum in patients with familial adenomatous polyposis (FAP), and to examine the relationship between age and severity of duodenal adenomatosis. DESIGN: Retrospective. METHOD: Using the FAP-registry of the Netherlands Foundation for the Detection of Hereditary Tumours, data were obtained from patients who had undergone a gastroduodenoscopy before 1 July 1999. The endoscopic and histological findings were used to classify the duodenal adenomas according to the Spigelman classification. RESULTS: 224 patients had undergone at least one gastroduodenoscopy 117 men and 107 women with a mean age at the time of the first endoscopy of 37 years (range 13-78). Fundic gland polyposis was detected in 79 patients (35%), stomach adenomas in 6 patients (3%) and duodenal adenomas in 92 patients (41%). A total of 21 patients (9%) had severe duodenal adenomatosis (Spigelman III or IV). Duodenal adenomatosis was often more severe if the patient was older. Ten patients were known to have duodenal cancer; the mean age at diagnosis was 50.3 years (range 39-67). CONCLUSION: Nearly 10% of the patients with FAP had developed severe duodenal adenomatosis. The severity of duodenal adenomatosis was related to the patient's age.