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

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 withcolonic 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.