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. 2020 Oct;34(10):4463-4471.
doi: 10.1007/s00464-019-07226-7. Epub 2019 Oct 21.

Select group of patients might benefit from early colonoscopic screening for colorectal cancer

Mohammad Bilal  1 , Shailendra Singh  2 , Thanh-Truc Le  1 , Yamam Al-Saadi  3 , Praveen Guturu  4
Affiliations

Select group of patients might benefit from early colonoscopic screening for colorectal cancer

Mohammad Bilal et al. Surg Endosc. 2020 Oct.

Abstract

Background: Recently, the American Cancer Society made a qualified recommendation to start colorectal cancer (CRC) screening at 45 years of age in all average-risk individuals. In this study, our primary aim is to calculate the prevalence and also evaluate the predictors of increased prevalence of detected adenomas in the 40-49-year-old individuals undergoing colonoscopy.

Methods: A retrospective cross-sectional study was performed using our endoscopy database. Study subjects included all 40-49-year-old patients undergoing their first colonoscopy at our institution from January 1, 2010 to September 30, 2017. Exclusion criteria included patients who underwent colonoscopy for overt gastrointestinal bleeding, inflammatory bowel disease, a history of familial adenomatous polyposis, hereditary non-polyposis CRC. Univariate analysis and multivariate analysis were performed to identify factors associated with increased adenoma detection rate (ADR).

Results: A total of 2059 patients were included in the study, and 317 of these patients had family history (FH) of CRC. Patients with FH of CRC had significantly higher ADR (27.8% vs. 19.7%, p = 0.001) as compared to those without FH of CRC. There was no significant difference in ADR in patients between 40-44 years and 45-49 years of age (17.7% vs. 21.4%, p = 0.058). On a multivariate analysis while adjusting for multiple patient and procedural variables, FH of CRC, male sex, BMI > 30 kg/m2, chronic kidney disease, and age were associated with high ADR.

Conclusions: Our study shows that in addition to FH of CRC, age, male sex, BMI, and CKD are independent predictors of increased ADR in patients between 40 and 49 years of age.

Keywords: Adenoma detection rate; Colon cancer; Colonoscopy; Early-onset colon cancer.

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References

    1. Siegel RL, Miller KD, Jemal A (2018) Cancer statistics, 2018. CA Cancer J Clin 68:7–30 - PubMed
    1. Zauber AG, Winawer SJ, O’Brien MJ et al (2012) Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. N Engl J Med 366:687–696 - DOI - PubMed - PMC
    1. Brounts LR, Lehmann RK, Lesperance KE et al (2009) Improved rates of colorectal cancer screening in an equal access population. Am J Surg 197:609–612 discussion 612-3 - DOI - PubMed
    1. Deen KI, Silva H, Deen R et al (2016) Colorectal cancer in the young, many questions, few answers. World J Gastrointest Oncol 8:481–488 - DOI - PubMed - PMC
    1. Rex DK, Boland CR, Dominitz JA et al (2017) Colorectal cancer screening: recommendations for physicians and patients from the U.S. multi-society task force on colorectal cancer. Gastroenterology 153:307–323 - DOI - PubMed

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