Prevalence, distribution, and risk factor for colonic neoplasia in 1133 subjects aged 40–49 undergoing screening colonoscopy

Abstract

Colorectal neoplasia prevalence in this 40- to 49-year-old Chinese cohort was higher than previous studies. Men, advancing age, FDR with CRC, and diabetes mellitus, can be used to risk stratify for neoplasia development. Men 45-49 years old with FDR with CRC represented the highest risk subgroup, with the lowest number needed to screen.

Risks of colorectal advanced neoplasia in young adults versus those of screening colonoscopy in patients aged 50 to 54 years

“…Alternatively, colonoscopy screening may be justified for high‐risk 45–49s cohorts, as male sex, current smoking, and hypertension were independent risk factors for advanced neoplasia of the young age cohort in this study. Male sex and current smoking were consistently found as independent risk factors for advanced neoplasia of the young age cohort in other studies . In our subgroup analysis (data not shown), the risk of advanced neoplasia in the 45–49s male smoker on screening colonoscopy was very similar to those in the 50–54s screening cohort (OR, 1.113, 95% CI, 0.823–1.506, P = 0.487).…”

“…Male sex and current smoking were consistently found as independent risk factors for advanced neoplasia of the young age cohort in other studies. [26][27][28][29] NNS, number needed to screen; CI, confidence interval. In our subgroup analysis (data not shown), the risk of advanced neoplasia in the 45-49s male smoker on screening colonoscopy was very similar to those in the 50-54s screening cohort (OR, 1.113, 95% CI, 0.823-1.506, P = 0.487).…”

Association between investigator-measured body-mass index and colorectal adenoma: a systematic review and meta-analysis of 168,201 subjects

“…Colorectal adenomas (CRA) are present in more than 30% of asymptomatic general populations [ 9 ]. Among all CRC screening participants who received colonoscopy with polyps detected, CRA is amongst the most frequent pathological findings [ 10 ]. Since most CRCs develop via genetic and morphological adenoma-carcinoma progression from CRAs, it is widely accepted that both CRCs and CRAs share similar epidemiological features and etiological causes.…”

“…Since most CRCs develop via genetic and morphological adenoma-carcinoma progression from CRAs, it is widely accepted that both CRCs and CRAs share similar epidemiological features and etiological causes. Hence, some risk algorithms have adopted BMI as a predictor variable to risk-stratify subjects for colorectal neoplasia [ 10 ].…”

Evidence-Based Guidelines for Screening Individuals With a Family History of Colorectal Cancer— More Questions Than Answers

“…Available prospective cohort data indicate that the incidence of advanced adenomas is approximately 2%-5% in both groups. 13,14 Separate retrospective data support this finding. 15,16 Although large, prospective cohort data demonstrate that follow-up colonoscopy within 5 years was beneficial for patients with FH of CRC, 17 studies should specifically look at results of repeat colonoscopy 5 years after a normal screening colonoscopy.…”