alexa Colorectal cancer screening in HIV-infected patients 50 years of age and older: missed opportunities for prevention.
Gastroenterology

Gastroenterology

Journal of Gastrointestinal & Digestive System

Author(s): Reinhold JP, Moon M, Tenner CT, Poles MA, Bini EJ

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Abstract OBJECTIVES: Although human immunodeficiency virus (HIV)-infected patients are now living longer, there are no published data on colorectal cancer (CRC) screening in this population. We hypothesized that HIV-infected patients were less likely to be screened for CRC compared to patients without HIV. METHODS: Consecutive HIV-infected patients > or =50 yr old seen in our outpatient clinic from 1/1/01 to 6/30/02 were identified. For each HIV-infected patient, we selected one age- and gender-matched control subject without HIV infection who was seen during the same time period. The electronic medical records were reviewed to determine the proportion of patients that had a fecal occult blood test (FOBT), flexible sigmoidoscopy, air-contrast barium enema (ACBE), or colonoscopy. RESULTS: During the 18-month study period, 538 HIV-infected outpatients were seen and 302 (56.1\%) were > or =50 yr old. Despite significantly more visits with their primary care provider, HIV-infected patients were less likely to have ever had at least one CRC screening test (55.6\%vs 77.8\%, p < 0.001). The proportion of HIV-infected patients who ever had a FOBT (43.0\%vs 66.6\%, p < 0.001), flexible sigmoidoscopy (5.3\%vs 17.5\%, p < 0.001), ACBE (2.6\%vs 7.9\%, p= 0.004), or colonoscopy (17.2\%vs 27.5\%, p= 0.002) was significantly lower than in control subjects. In addition, HIV-infected patients were significantly less likely to be up-to-date with at least one CRC screening test according to current guidelines (49.3\%vs 65.6\%, p < 0.001). CONCLUSIONS: A substantial number of HIV-infected patients are > or =50 yr of age and CRC screening is underutilized in this population. Public health strategies to improve CRC screening in HIV-infected patients are needed. This article was published in Am J Gastroenterol and referenced in Journal of Gastrointestinal & Digestive System

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