Lack of Association between Inguinal Hernia and Carcinoma of the Colon

Brendel, Thomas H.; Kirsh, Israel E.

doi:10.1056/nejm197102182840709

Cited by 22 publications

(12 citation statements)

References 3 publications

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“…In our study, no case of colon cancer was discovered in 100 asymptomatic patients with inguinal hernia. Similar results were reported by Brendel and co‐workers, who failed to detect a single case of asymptomatic cancer among their 312 patients awaiting hernia repair 10 . In other studies where colon cancer was found associated with inguinal hernia, the overall rate was not significantly different from the rates in our study.…”

Section: Discussionsupporting

confidence: 91%

“…A positive relationship between inguinal hernia and colorectal cancer had its defenders and detractors, leaving as a matter of debate the question of whether all patients with inguinal hernia should be screened for colorectal cancer. [3][4][5][6][7][8][9][10][11][12][13][14] Using flexible sigmoidoscopy for screening, our study showed that benign and malignant colonic neoplasms were equally common among otherwise asymptomatic men with or without inguinal hernia. In patients without characteristic gastrointestinal symptoms, such as constipation, changes in bowel habits, pain or haematochezia, the occurrence of inguinal hernia alone does not serve as a sentinel sign for the concurrent presence of colorectal cancer.…”

Section: Discussionmentioning

confidence: 99%

“…Other investigators have contested these recommendations, as their studies yielded few colorectal cancers among patients with inguinal hernia. [10][11][12][13][14] The earliest studies used rigid sigmoidoscopy, with or without single contrast barium enema, for screening. Subsequent investigators utilized a flexible 60 cm fibreoptic sigmoidoscope to screen their patients with inguinal hernia.…”

Section: Introductionmentioning

confidence: 99%

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

Avidan¹,

Sonnenberg²,

Bhatia³

et al. 2002

Aliment Pharmacol Ther

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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.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Avidan¹,

Sonnenberg²,

Bhatia³

et al. 2002

Aliment Pharmacol Ther

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“…Gravity [2], raised intra-abdominal pressure secondary to the tumour development, straining on defaecation or partial intestinal obstruction have been said to contribute to the development of hernias. However, studies have found no causative relationship between inguinal hernia and colonic malignancies [8,9]. The current consensus is that patients with inguinal hernias should undergo screening for colon cancer at the same rate as the general population [10].…”

Section: Discussionmentioning

confidence: 99%

Synchronous colonic carcinomas presenting as an inguinoscrotal hernial mass: a case report

et al. 2007

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BackgroundA carcinoma within a hernia in the groin is uncommon, with an incidence of less than 0.5 percent of all excised sacs. This article describes a case of synchronous colonic carcinomas, one of which presented as an inguinoscrotal mass.Case presentationA 69-year old man presented with a large, irreducible left inguinoscrotal hernia and symptoms of obstruction. On examination, there was an 8 cm palpable mass within the hernia sac. CT scan revealed small and proximal large bowel obstruction secondary to a large ingunoscrotal sac and synchronous colonic tumours of the transverse colon and the ascending colon. The former presented as an inguinoscrotal mass. Laparotomy revealed a large tumour mass arising from the transverse colon in the hernia sac. The procedure was followed by an extended right hemicolectomy, during which the second tumour in the ascending colon was also resected.ConclusionThis case demonstrates a rare but interesting occurrence of primary transverse colon carcinoma presenting in a hernia sac, in conjunction with a synchronous tumour of the ascending colon. Prognosis is comparable to patients with a solitary tumour of similar pathological staging when the resection is curative. The presence of an inguinal hernia itself does not signify an increased risk of colorectal malignancy. However, in the presence of obstruction, incarceration, and weight loss, malignancy should be suspected. Thorough clinical examination, flexible sigmoidoscopy or radiographic evaluation is necessary preoperatively in such patients. Surgical resection, with or without adjuvant oncological treatment, should be performed as soon as possible, using established techniques with modifications according to involvement of local structures.

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“…Recent studies report the yield of barium enemas to be so low that this procedure should not be used for evaluation of symptomatic hernias, unless specific symptoms of colonic disease are present [5,7,9,13].…”

Section: Discussionmentioning

confidence: 99%