Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Dec;22(12):2517-2525.e3.
doi: 10.1016/j.cgh.2024.04.029. Epub 2024 May 9.

Early-onset Colorectal Cancer Patients Do Not Require Shorter Intervals for Post-surgical Surveillance Colonoscopy

Robin B Mendelsohn  1 , Anne I Hahn  2 , Randze Lerie Palmaira  3 , Asha R Saxena  4 , Pavan Kedar Mukthinuthalapati  5 , Mark A Schattner  6 , Arnold J Markowitz  6 , Emmy Ludwig  6 , Pari Shah  6 , Delia Calo  6 , Hans Gerdes  6 , Rona Yaeger  4 , Zsofia Stadler  4 , Ann G Zauber  2 , Andrea Cercek  4
Affiliations

Early-onset Colorectal Cancer Patients Do Not Require Shorter Intervals for Post-surgical Surveillance Colonoscopy

Robin B Mendelsohn et al. Clin Gastroenterol Hepatol. 2024 Dec.

Erratum in

  • Correction.
    [No authors listed] [No authors listed] Clin Gastroenterol Hepatol. 2025 Jul;23(8):1464. doi: 10.1016/j.cgh.2025.03.001. Epub 2025 Apr 16. Clin Gastroenterol Hepatol. 2025. PMID: 40252690 No abstract available.

Abstract

Background & aims: Early-onset colorectal cancer (EO-CRC), diagnosed before age 50, is rising in incidence worldwide. Although post-surgical colonoscopy surveillance strategies exist, appropriate intervals in EO-CRC remain elusive, as long-term surveillance outcomes remain scant. We sought to compare findings of surveillance colonoscopies of EO-CRC with patients with average onset colorectal cancer (AO-CRC) to help define surveillance outcomes in these groups.

Methods: Single-institution retrospective chart review identified EO-CRC and AO-CRC patients with colonoscopy and no evidence of disease. Surveillance intervals and time to development of advanced neoplasia (CRC and advanced polyps [adenoma/sessile serrated]) were examined. For each group, 3 serial surveillance colonoscopies were evaluated. Statistical analyses were performed utilizing log-ranked Kaplan-Meier method and Cox proportional hazards.

Results: A total of 1259 patients with CRC were identified, with 612 and 647 patients in the EO-CRC and AO-CRC groups, respectively. Compared with patients with AO-CRC, patients with EO-CRC had a 29% decreased risk of developing advanced neoplasia from time of initial surgery to first surveillance colonoscopy (hazard ratio, 0.71; 95% confidence interval, 0.52-1.0). Average follow-up time from surgical resection to first surveillance colonoscopy was 12.6 months for both cohorts. Overall surveillance findings differed between cohorts (P = .003), and patients with EO-CRC were found to have less advanced neoplasia compared with their counterparts with AO-CRC (12.4% vs 16.0%, respectively). Subsequent colonoscopies found that, while patients with EO-CRC returned for follow-up surveillance colonoscopy earlier than patients with AO-CRC, the EO-CRC cohort did not have more advanced neoplasia nor non-advanced adenomas.

Conclusions: Patients with EO-CRC do not have an increased risk of advanced neoplasia compared with patients with AO-CRC and therefore do not require more frequent colonoscopy surveillance than current guidelines recommend.

Keywords: Adenoma; Colonoscopy; Early-onset Colorectal Cancer; Neoplasia; Surveillance.

PubMed Disclaimer

References

    1. Siegel RL, Torre LA, Soerjomataram I, et al. Global patterns and trends in colorectal cancer incidence in young adults. Gut Sep 5 2019;doi:10.1136/gutjnl-2019-319511 - DOI - PubMed
    1. Vuik FE, Nieuwenburg SA, Bardou M, et al. Increasing incidence of colorectal cancer in young adults in Europe over the last 25 years. Gut Oct 2019;68(10):1820–1826. doi:10.1136/gutjnl-2018-317592 - DOI - PMC - PubMed
    1. Stoffel EM, Koeppe E, Everett J, et al. Germline Genetic Features of Young Individuals With Colorectal Cancer. Gastroenterology. Mar 2018;154(4):897–905.e1. doi:10.1053/j.gastro.2017.11.004 - DOI - PMC - PubMed
    1. Cercek A, Chatila WK, Yaeger R, et al. A Comprehensive Comparison of Early-Onset and Average-Onset Colorectal Cancers. Journal of the National Cancer Institute. Nov 29 2021;113(12):1683–1692. doi:10.1093/jnci/djab124 - DOI - PMC - PubMed
    1. Vogelstein B, Fearon ER, Hamilton SR, et al. Genetic alterations during colorectal-tumor development. The New England journal of medicine. Sep 1 1988;319(9):525–32. doi:10.1056/nejm198809013190901 - DOI - PubMed

LinkOut - more resources