Spectrum of Advanced Colorectal Neoplasia and Anticipated Yield of Average-Risk Screening in Veterans Under Age 50

Yen, Timothy; Scolaro, Jack; Montminy, Eric M.; Karlitz, Jordan J.; Wani, Sachin; Patel, Swati; Estrada, Viridiana; Espinoza, Jeannine; Lewis, Carmen L.; Scott, Frank I.; Tarter, Wyatt; Hochheimer, Camille J.

doi:10.1016/j.cgh.2021.11.017

Cited by 8 publications

(7 citation statements)

References 7 publications

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“…Shaukat et al 11 reported an advanced neoplasia detection rate of 3.3% among average-risk individuals aged 45 to 49 years in a large community practice, but the investigators' more expansive definition of advanced neoplasia included both advanced serrated lesions and 5 or more precancerous lesions, making it difficult to directly compare with the other studies. Yen et al 15 found the prevalence of advanced neoplasia including serrated lesions in a population of predominantly male 45-to 49-year-olds with low-risk symptoms at a single Department of Veterans Affairs medical center was 8.5%. We found a 6.2% advanced neoplasia prevalence among men in the same age group, which may indicate that the general population has a lower prevalence of risk factors for colorectal neoplasia compared with veterans who receive care in the Department of Veterans Affairs.…”

Section: Discussionmentioning

confidence: 99%

Age-Stratified Prevalence and Predictors of Neoplasia Among U.S. Adults Undergoing Screening Colonoscopy in a National Endoscopy Registry

Liang

Williams²,

Dominitz

et al. 2022

Gastroenterology

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Section: Discussionmentioning

confidence: 99%

Age-Stratified Prevalence and Predictors of Neoplasia Among U.S. Adults Undergoing Screening Colonoscopy in a National Endoscopy Registry

Liang

Williams²,

Dominitz

et al. 2022

Gastroenterology

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“…1 Currently, early-onset colorectal neoplasms, which develop before 50 years of age, are a hot research topic as their incidence increases in Western and Eastern countries. [2][3][4][5][6][7][8][9][10][11] Several studies have identified the risk and preventive factors for early-onset colorectal neoplasms in Western countries. Obesity, Western diet, smoking, and alcohol and meat consumption are the predominant risk factors for early-onset colorectal neoplasms.…”

Section: Introductionmentioning

confidence: 99%

“…Colorectal cancer (CRC) is the leading cause of cancer‐related deaths worldwide and is the second and third most commonly diagnosed cancer in women and men, respectively 1 . Currently, early‐onset colorectal neoplasms, which develop before 50 years of age, are a hot research topic as their incidence increases in Western and Eastern countries 2–11 …”

Section: Introductionmentioning

confidence: 99%

Risk and preventive factors of early‐onset colorectal neoplasms: endoscopic and histological database analysis

Arai

Aoki

Hayakawa

et al. 2022

J of Gastro and Hepatol

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Background and Aim:The incidence of early-onset colorectal neoplasms has been increasing in both Western and Eastern countries. However, the risks and preventive factors for these neoplasms in Eastern countries remain unclear. Methods: The data of 5580 patients who underwent colonoscopy between 2016 and 2021 were retrospectively evaluated. The primary outcome was advanced colorectal neoplasm (ACRN), defined as advanced adenomas (adenoma ≥10 mm, or with high-grade dysplasia or villous component) or adenocarcinoma. The clinical factors associated with ACRNs were determined for each age category (≤50 and >50 years), and the differences between the two categories were assessed. Odds ratios adjusted for age and sex were calculated. Results: Among 1001 patients (age ≤50 years), ACRN was found in 94 (9.4%). In this younger category, male sex (adjusted odds ratio [aOR]:2.34, 95% confidence interval [CI]:1.51-3.63) and a family history of colorectal cancer (aOR:2.14, 95% CI:1.17-3.89) were significantly associated with higher odds of developing ACRNs. ACRNs were detected in 726 (15.9%) of 4579 patients (age >50 years). In the older age category, smoking (aOR:1.32, 95% CI:1.08-1.63) was significantly associated with a higher risk of ACRNs. Exercise of >3.5 metabolic equivalent of task (METs) (aOR,0.80; 95% CI:0.67-0.96) was significantly associated with a lower risk of ACRNs. Conclusion:The development of early-onset ACRNs was primarily associated with congenital factors, whereas that of late-onset ACRNs was associated with acquired ones. Colonoscopy is recommended for young male patients, particularly for those with a family history of colorectal cancer.

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“…The findings from this study by Anderson et al were similar to the results of this study. Other recent studies evaluated the incidence of AN on index colonoscopy in younger individuals but did not assess surveillance findings (32,33).…”

Section: Discussionmentioning

confidence: 99%

The Risk of Metachronous Advanced Neoplasia After Colonoscopy in Patients Aged 40–49 Years Compared With That in Patients Aged 50–59 Years

Anderson

Liu

et al. 2022

Am J Gastroenterol

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INTRODUCTION: This study investigated the risk of metachronous advanced neoplasia (AN) after colonoscopy in individuals aged 40-49 years compared with that in individuals aged 50-59 years. METHODS:A retrospective cohort study was performed among Kaiser Permanente Northern California members aged 40-59 years who had their first (index) colonoscopy in 2010-2013. Participants were followed up until death, disenrollment, AN on surveillance colonoscopy, or December 31, 2018. The risk for the development of AN was estimated using the Cox regression, adjusted for confounders. RESULTS:The study included 11,374 patients (2,396 aged 40-49 years and 8,978 aged 50-59 years). When comparing the 40-49 years group with the 50-59 years group, AN was detected in 2.2% vs 4.4% (P 5 0.0003) on surveillance colonoscopy after index colonoscopy finding of no adenoma, in 4.6% vs 7.0% (P 5 0.03) after a finding of nonadvanced adenoma (NAA), and in 7.9% vs 11.7% (P 5 0.06) after a finding of advanced adenoma (AA), respectively. Compared with the 50-59 years group, the 40-49 years group had a lower risk of metachronous AN when no adenoma was detected on index colonoscopy (hazard ratio [HR] 0.58; 95% confidence interval [CI] 0.39-0.83) and no difference when NAA (HR 0.84; 95% CI 0.54-1.24) or AA (HR 0.83; 95% CI 0.51-1.31) was detected. DISCUSSION:Compared with patients aged 50-59 years, patients aged 40-49 years may have a lower risk of developing metachronous AN when no adenoma is detected on index colonoscopy and a similar risk when NAA or AA is detected. These data suggest current surveillance colonoscopy guidelines may be applicable to patients aged 40-49 years who undergo colonoscopy.

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Spectrum of Advanced Colorectal Neoplasia and Anticipated Yield of Average-Risk Screening in Veterans Under Age 50

Cited by 8 publications

References 7 publications

Age-Stratified Prevalence and Predictors of Neoplasia Among U.S. Adults Undergoing Screening Colonoscopy in a National Endoscopy Registry

Age-Stratified Prevalence and Predictors of Neoplasia Among U.S. Adults Undergoing Screening Colonoscopy in a National Endoscopy Registry

Risk and preventive factors of early‐onset colorectal neoplasms: endoscopic and histological database analysis

The Risk of Metachronous Advanced Neoplasia After Colonoscopy in Patients Aged 40–49 Years Compared With That in Patients Aged 50–59 Years

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