Colonoscopy Screening for Colon Polyps: May be Useful at an Earlier Age in Prevention of Malignant Transformation?

Abstract

Objective The objective of this study was to investigate whether colonoscopy screening should be performed at an earlier age than specified in the current guidelines. Method: Data of 1882 patients who presented to the gastroenterology clinic of our hospital and underwent colonoscopy were retrospectively evaluated. Polyps detected during colonoscopy were excised and sent to the pathology laboratory for histopathological examination. Patients were divided into two groups as < 45 yo and ≥ 45 yo and the data were compared between the groups. Results The most common indications for colonoscopy were found as abdominal pain in 40.6%, rectal bleeding in 18.6%, constipation in 14.2%, anemia in 10.5%, diarrhea in 3.1% and other reasons in 6.8% of the patients. The rate of polyps was statistically significantly higher in ≥ 45 yo patients (43.3%) compared to < 45 yo patients (32.1%). The rate of neoplastic polyps was statistically significantly higher in ≥ 45 yo group compared to < 45 yo group. The most common localizations of polyps were rectum and sigmoid colon in all age groups. Three endoscopists performed the procedures and one of them with more experrience detected more polyps. Conclusion Based on our results, we believe that onset age of screening for colon polyps should be 45 years as recommended by the updated guidelines. In addition, colonoscopy screening should be performed in young adults without alarm symptoms who present with abdominal pain. Experience of the endoscopist, bowel cleaning and duration of withdrawing fom the cecum affects the number of detected polyps.