Older Age at First Screening Colonoscopy is Associated With an Increased Risk of Colorectal Adenomas and Cancer

Abstract

Introduction: The goal of colorectal cancer (CRC) screening is to detect precancerous polyps before cancer development or identification of cancer at an early stage. Guidelines have recommended screening colonoscopy to start at age 45. Our aim was to determine the impact of delays in performing the first screening colonoscopy on the risk of adenoma or CRC detection. Methods: We analyzed colonoscopy and histopathology data of average CRC risk patients who had their first screening colonoscopy between 2010 and 2017. Univariate and multivariable logistic regression was performed to determine the association between demographic variables and the risk of adenomas or CRC. Results: A total of 1155 average risk patients underwent their initial screening colonoscopy during the study period. Median age was 54 years (range of 45-87) and 58.2% were females. In multivariable analysis, older age at first screening colonoscopy was significantly associated with the detection of adenomatous polyps (odds ratio 1.05, 95% confidence interval 1.04-1.07, P<0.001) and CRC (odds ratio 1.11, 95% confidence interval 1.06-1.16, P<0.001). The association between age and risk of adenomatous polyps (F-test 35.43, P=0.0019) and CRC (F-test 36.94, P=0.0017) fit an exponential growth model. It was estimated that the detection rate doubled every 14.20 years and 4.75 years for adenomas and CRC, respectively. Conclusion: We found that older age at the initial performance of a screening colonoscopy was associated with increased detection of adenomatous polyps and CRC. This work highlights the need for guideline adherence for the prevention of CRC development.

Telomere Length as a New Risk Marker of Early-Onset Colorectal Cancer

“…Nowadays, it is critically relevant, especially in high-incidence geographic areas, to identify markers that allow us to select the population at risk of developing EOCRC, as most individuals younger than 50 years are not considered for CRC screening strategies, as they are part of the average-risk population [ 2 ]. In fact, it has been reported that older age at the time of screening colonoscopy is associated with an increased rate of detection of adenomatous polyps and CRC [ 7 ]. This highlights the need for adherence to guidelines to prevent the development of CRC, as well as the identification of useful markers to facilitate the early detection of this disease.…”

45 Is the new 50: improving colon cancer screening rates

“…The older that patients start colonoscopy screening, the higher likelihood of detecting adenomatous polyps and CRC [14 ▪ ].…”