Publications by authors named "Marco C J M Becx"

3 Publications

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Randomized Comparison of Surveillance Intervals in Familial Colorectal Cancer.

J Clin Oncol 2015 Dec 2;33(35):4188-93. Epub 2015 Nov 2.

Simone D. Hennink, Andrea E. van der Meulen-de Jong, Ron Wolterbeek, A. Stijn L.P. Crobach, Roeland A. Veenendaal, Hans Morreau, and Hans F.A. Vasen, Leiden University Medical Center; Wiet F.S.J. Crobach, W. Rogier ten Hove, and Anne M.C. Witte, Diaconessenhuis, Leiden; Marco C.J.M. Becx, St Antonius Hospital, Nieuwegein; Michiel van Haastert and Hugo J. Wolters, Martini Hospital; Jan H. Kleibeuker, University Medical Center Groningen, Groningen; Maarten A.C. Meijssen, Juda Vecht, Wouter H. de Vos tot Nederveen Cappel, and Dik Westerveld, Isala Clinics, Zwolle; Fokko M. Nagengast, Radboud University Medical Center, Nijmegen; Marno C.M. Rijk, Amphia Hospital, Breda; Jan M.J.I. Salemans and Marie-Louise Verhulst, Máxima Medical Center; Arnold Stronkhorst, Catharina Hospital, Eindhoven; Hans A.R.E. Tuynman, Medical Center Alkmaar, Alkmaar; Herman Walinga, Reinier de Graaf Gasthuis, Delft; Olaf K. Weinhardt, Scheper Hospital, Emmen; and Annemieke Cats, National Cancer Institute, Amsterdam, the Netherlands.

Purpose: Colonoscopic surveillance is recommended for individuals with familial colorectal cancer (CRC). However, the appropriate screening interval has not yet been determined. The aim of this randomized trial was to compare a 3-year with a 6-year screening interval.

Patients And Methods: Individuals between ages 45 and 65 years with one first-degree relative with CRC age < 50 years or two first-degree relatives with CRC were selected. Patients with zero to two adenomas at baseline were randomly assigned to one of two groups: group A (colonoscopy at 6 years) or group B (colonoscopy at 3 and 6 years). The primary outcome measure was advanced adenomatous polyps (AAPs). Risk factors studied included sex, age, type of family history, and baseline endoscopic findings.

Results: A total of 528 patients were randomly assigned (group A, n = 262; group B, n = 266). Intention-to-treat analysis showed no significant difference in the proportion of patients with AAPs at the first follow-up examination at 6 years in group A (6.9%) versus 3 years in group B (3.5%). Also, the proportion of patients with AAPs at the final follow-up examination at 6 years in group A (6.9%) versus 6 years in group B (3.4%) was not significantly different. Only AAPs at baseline was a significant predictor for the presence of AAPs at first follow-up. After correction for the difference in AAPs at baseline, differences between the groups in the rate of AAPs at first follow-up and at the final examination were statistically significant.

Conclusion: In view of the relatively low rate of AAPs at 6 years and the absence of CRC in group A, we consider a 6-year surveillance interval appropriate. A surveillance interval of 3 years might be considered in patients with AAPs and patients with ≥ three adenomas.
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http://dx.doi.org/10.1200/JCO.2015.62.2035DOI Listing
December 2015

[Screening: management after incomplete colonoscopy could be improved].

Ned Tijdschr Geneeskd 2014 ;158:A7195

St. Antonius Ziekenhuis, afd. Maag-Darm-Leverziekten, Nieuwegein.

In 2014 in the Netherlands a national screening programme for bowel cancer was started in which a colonoscopy is performed after a positive immunochemical faecal occult blood test. If colonoscopy is incomplete a CT colonography (CTC) is offered in order to visualize the remaining colon. Balloon endoscopy (BE), double- or single-balloon, is an effective and safe endoscopic alternative which has advantages over CTC, including the option of endoscopic polypectomy and histological examination. However, its cost and the need for an additional procedure on a different day are disadvantageous. BE deserves a place in the national screening programme for bowel cancer after an incomplete colonoscopy, as a possible alternative for CTC and certainly after finding polyps on CTC. Because expertise in BE and its availability are limited, in each screening region some centres should be appointed as designated referral centres to perform BE.
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November 2014

Severe hepatic side effects of ezetimibe.

Clin Gastroenterol Hepatol 2006 Jul 22;4(7):908-11. Epub 2006 Jun 22.

Department of Gastroenterology, St. Antonius Hospital, Nieuwegein, The Netherlands.

Background And Aims: Ezetimibe was introduced recently as a new class of cholesterol-lowering drugs. Until now only limited increases of transaminase levels were reported.

Methods: We studied 2 patients with severe hepatic side effects of ezetimibe in a general community hospital.

Results: Ezetimibe may lead to 2 distinct types of severe hepatic side effects.

Conclusions: Ezetimibe may rarely cause hepatotoxicity, severe cholestatic hepatitis, or acute autoimmune hepatitis.
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http://dx.doi.org/10.1016/j.cgh.2006.04.014DOI Listing
July 2006