Characteristics of and risk factors for colorectal neoplasms in young adults in a screening population

Lee, Seung Eun; Jo, Hee Bum; Kwack, Won Gun; Jeong, Yun Jin; Yoon, Yeo Jin; Kang, Hyoun Woo

doi:10.3748/wjg.v22.i10.2981

Cited by 38 publications

(69 citation statements)

References 43 publications

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“…However, several studies have reported increasing incidence of CRC in adults under the age of 50 years; meanwhile, incidence and mortality rates in individuals over 50 are decreasing [ 7 8 9 10 11 ]. Furthermore, the prevalence of adenoma in asymptomatic healthy young-aged adults of under 50 has been reported to range from 12.5%–36%, almost equivalent to that of the elderly aged 50–60 years [ 12 13 14 15 ]. Although most adenomas stabilize and regress, removal of low-risk adenomas is reported to be effective showing 25% reduction of mortality as compared with CRC mortality rates in the general population [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

“…Because the frequency of colorectal adenoma in young-aged adults should not be overlooked given that the majority of CRC is known to develop from colorectal adenomas through the well-known process of adenomacarcinoma sequence [ 17 ], continuous efforts have been made to clarify the risk factors for development of adenoma in young-aged adults. Several studies have proposed male sex, current smoker, alcohol consumption, obesity, and screening for colorectal adenoma as common risk factors, and those clinical factors could be indications for screening of colorectal adenoma in young-aged individuals [ 12 13 14 15 18 ].…”

Section: Introductionmentioning

confidence: 99%

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Anatomical distribution and detection rate of colorectal neoplasms according to age in the colonoscopic screening of a Korean population

Lee

Song²,

et al. 2018

Ann Surg Treat Res

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PurposeBecause data as a basis for the determination of proper age and modality for screening of colorectal neoplasms is lacking, we evaluated detection rates and anatomical distribution of colorectal neoplasms according to age in healthy individuals who underwent total colonoscopy for health checkup.MethodsA total of 16,100 cases that had received the colonoscopic examination from January to December in 2014 were analyzed. The total number of individuals who received total colonoscopy were divided by the number of individuals harboring colorectal adenoma to calculate the detection rate of colorectal adenoma. Individuals ≤50 years old were classified as young-age group and aged >50 were old-age group. Differences in anatomical locations of colorectal neoplasms were analyzed in the 2 age groups by chi-square test. Risk factors for colorectal adenoma in each age group were analyzed using univariate and multivariate logistic regression analyses.ResultsDetection rates of colorectal adenoma were 13.7% in all cases and 12.8% for those in their 40′s. The main anatomical location of colorectal adenoma was proximal colon in both age groups (P < 0.001). Hyperplastic polyp was mainly distributed to the distal colon in both age groups (P < 0.001). Distal colon was the major site for colorectal cancer in the old-age group (P = 0.001). Proximal location of neoplasms was a risk factor for colorectal adenoma in both age groups with multivariate analysis.ConclusionThese data could be the bases for earlier initiation of screening for colorectal neoplasms with total colonoscopy to detect clinically significant colorectal polyps.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Anatomical distribution and detection rate of colorectal neoplasms according to age in the colonoscopic screening of a Korean population

Lee

Song²,

et al. 2018

Ann Surg Treat Res

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“…Obesity and diet are associated with increased risk for CRC, and the rate of obesity among Americans has been reported to be as high as 34% (22). Physical inactivity, lack of exercise, tobacco use and consumption of alcohol are also related to increased CRC risk (23,24). These behavioral risk factors are more pervasive in populations with lower socioeconomic status in the US, thereby reflecting a relationship of demographic disparities and behavioral patterns that is associated with CRC (25,26).…”

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confidence: 99%

Age-related rates of colorectal cancer and the factors associated with overall survival

Gabriel

Attwood

Al-Sukhni

et al. 2018

J. Gastrointest. Oncol.

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Background: The purpose of this study was to identify differences in both demographic and pathologic factors associated with the age-related rates of colorectal cancer (CRC) and overall survival (OS). Methods: The National Cancer Data Base (NCDB), [2004][2005][2006][2007][2008][2009][2010][2011][2012][2013], was queried for patients with CRC. Patients were stratified by age (≤50 vs. ≥60 years). Multivariable analysis was performed to identify factors associated with OS.Results: A total of 670,030 patients were included; 488,121 with colon, and 181,909 with rectal or rectosigmoid cancer. For colon cancer, patients ≤50 years had higher proportions of pathologic stage III and IV disease than patients ≥60 (III: 33.7% vs. 28.6%, IV: 25.5% vs. 14.3%, respectively; P≤0.001). Similar differences were found for patients with rectal cancer (III: 35.8% vs. 28.6%, IV: 16.5% vs. 11.6%, respectively for age ≤50 and ≥60 years; P≤0.001). More aggressive pathologic factors were identified in the ≤50 cohort and were associated with worse OS, including higher tumor grade, lymphovascular invasion (LVI), perineural invasion (PNI), and elevated serum carcinoembryonic antigen (CEA). Disparities associated with OS were also identified for both colon and rectal cancer. For patients ≤50 with CRC, African-American and Hispanic race, lower income and lower education were associated with increased risk of mortality compared to the ≥60 cohort. Conclusions: There are clear differences in biological factors and in racial and socioeconomic disparities of patients with early onset CRC. Earlier screening should be seriously considered in patients under 50 years who are African-American and Hispanic, as these populations present with more aggressive and advanced disease. Changes in risk factors among younger adults over time, including diets higher in fat and increasing obesity, are also in part, contributing to this rising trend (8,9).In addition to these biologic etiologies, disparities in access to care for diagnosis and treatment of CRC among young adults has also been described. Several studies have characterized differences in the treatment of CRC, including access to surgery and chemotherapy based on age, race, geographic location and other socioeconomic factors like insurance status and income (10)(11)(12)(13)(14)(15). Importantly, differences in access to these treatments have been associated with worse survival outcomes for patients with early-onset CRC of minority racial populations (16,17). The purposes of this study were to identify differences in both demographic and pathologic factors associated with the age-related rates of CRC and to assess the interaction these variables on overall survival (OS) in early onset CRC. Methods PatientsJointly sponsored by the American Cancer Society and the American College of Surgeons, the National Cancer Data Base (NCDB) captures approximately 70% of the country's cancer cases through its participating hospitals. A query of the NCDB 2006-2012 participant user files (PUFs) was performed to identify ...

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“…A population study is needed to further investigate the incidence, mortality and risks of colorectal cancer in this country. This is important because screening may then be implemented in higher risk groups such as those with central obesity, strong smoking history and significant alcohol consumption even at a younger age [14].…”

Section: Resultsmentioning

confidence: 99%

A Single Centre Retrospective Review of Colorectal Cancer in Trinidad over a Three Year Period

Rampersad¹,

Mohammed²,

Jurawan³

2017

GHOA

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A Single Centre Retrospective Review of Colorectal Cancer in Trinidad over a Three Year PeriodSubmit Manuscript | http://medcraveonline.com Abbreviations: GI: Gastrointestinal; CRC: Colorectal Cancer IntroductionColorectal cancer (CRC) is listed as the third most common cancer globally and accounts for 9.7% of all cancers (excluding non-melanoma skin cancer). It is listed as the third most common type of cancer in men and the second most common in women [1]. Colorectal cancer represents the fourth most common cause of cancer death worldwide [2]. According to the PAHO 2013 report, it is a growing burden in Latin America and the Caribbean. In Trinidad & Tobago it is the third most common type of cancer (12%) in men and women (11%) [3].Increasing age has been listed as a risk factor for CRC [4]. The likelihood of diagnosis of CRC increases after the age of 40 [5]. The National Cancer Institute SEER cancer statistics review shows that in excess of 90 percent of cases of colorectal cancer are found in patients over the age of 50 in a US population [6]. However, this registry predicts that there will be a 90% increase in the rate of colon cancers in persons 20-39 years and a 124% increase in rectal cancers by 2030. There are gender differences in CRC. The incidence of CRC is higher in females than in males, when considering persons older and 65 years [7,8]. The 5-year survival rate for colorectal cancer in females, over the age of 70, is higher than that for males [7].In a review of the literature it was found that patients with right-sided CRC were more likely to be female, have poorly differentiated tumors and present with larger tumors [9]. A German study found that patients with right-sided colon cancer also tended to present with vague symptoms and this was associated with later presentation and more advanced stage at presentation [10]. One United States study has shown an increase in right compared to left-sided lesions [11]. Materials and MethodsThis is a retrospective study of all cases of colorectal cancer identified by endoscopy at the Port-of-Spain General Hospital in North Trinidad. Permission to conduct this study was granted from the Medical Director at the institution. a. Inclusion criteria: All endoscopy reports over a three year period from January 2012 to December 2015 were included in the study if the overall appearance was suggestive of a malignant lesion.b. Exclusion criteria: Polyps and lesions that appeared benign at endoscopy were excluded.Data were collected to determine the reason for referral for lower gastrointestinal endoscopy and the site of the lesion Rightsided lesions were taken as those that were found in the ascending colon, including the caecum, and up to the proximal half of the transverse colon. Left-sided lesions were taken as the distal half of the transverse colon, the descending and sigmoid colon and rectum. Demographic information was collected. The data was analyzed using Microsoft Excel and SPSS Version 22. Results and DiscussionA total of 118 cases of suspected colorectal ...

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Characteristics of and risk factors for colorectal neoplasms in young adults in a screening population

Abstract: Current screening strategies for colorectal cancer may need to be amended to account for patient age, especially in young subjects with abdominal obesity, current smoking and alcohol consumption.

Cited by 38 publications

References 43 publications

Anatomical distribution and detection rate of colorectal neoplasms according to age in the colonoscopic screening of a Korean population

Anatomical distribution and detection rate of colorectal neoplasms according to age in the colonoscopic screening of a Korean population

Age-related rates of colorectal cancer and the factors associated with overall survival

A Single Centre Retrospective Review of Colorectal Cancer in Trinidad over a Three Year Period

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