Inguinal hernia is not a sign of colon cancer: results of a prospective screening trial

Abstract

Background: It has been suggested that patients with an inguinal hernia harbour an increased risk for colorectal cancer. Methods: In a prospective clinical trial, we compared the prevalence of colonic neoplasms in 100 cases with inguinal hernia and 100 controls without inguinal hernia. The number, size, histology type, and the location of all colorectal lesions found during a screening flexible sigmoidoscopy were recorded. Results: Not a single case of colorectal cancer was detected in the patients with inguinal hernia pending surgical repair. In the asymptomatic control subjects, one Dukes A and one Dukes B1 colon cancer were detected. Polypectomy was performed in 15% and 17% of the case and control subjects, respectively. During a 5‐year period following the initial screening procedure, none of the case or control subjects was diagnosed with colon cancer. Conclusions: The decision for or against performing an endoscopic procedure in a patient with inguinal hernia should be guided by the general principles of screening for colorectal cancer. The mere presence of an inguinal hernia does not automatically increase the risk of colorectal cancer.

Colonic carcinoma presenting as strangulated inguinal hernia: report of two cases and review of the literature

“…cer diagnosis [20,21], a prospective case control study found no association between inguinal hernia and colonic carcinoma [22,23].…”

A Rare Case of Sigmoid Colon Carcinoma in Incarcerated Inguinal Hernia

“…Hypotheses that circulatory distress and the consequent inflammation of the herniated bowel were responsible for the onset of the intrasaccular tumor were formulated in the past; currently, a direct association between these two common pathologies is considered implausible [11]. No significant association between inguinal hernia and colon cancer was reported [12,13], but if there are cancer-related symptoms in patients (weight loss, rectal bleeding, abdominal pain), it is important that the radiologist considers the chance for a colon tumor in an inguinoscrotal hernia.…”

Is a routine preoperative rectosigmoidoscopy necessary in patients with bilateral inguinal hernia?

“…Inguinal hernia and colorectal cancer are more frequent in men and elderly population (4,10,12,13). Inguinal hernias are more common in men, thought to be related to the anatomical differences between the male and female pelvis.…”

“…In general, the male pelvis is narrow, the pubic arch is lower, the inguinal canal is shorter, and the shutter mechanism is considerably weaker (14). With increased age, in addition to weakening of support tissue, obstructive uropathy, severe coughing, and chronic pulmonary diseases facilitate the development of inguinal hernia (10). It is also reported that smoking, long-term heavy labor work, the diseases characterized by abnormal collagen production, and abdominal aorta aneurysm play a role in inguinal hernia development (14).…”

“…After that, some researchers began to recommend routine preoperative colorectal screening in patients with inguinal hernia (3)(4)(5)(6)(7). Then this association was questioned in some studies, and data had not verifi ed the results (8)(9)(10)(11). However, there have been no studies published on the association between sudden bilateral inguinal hernias and colorectal pathologies.…”