Detroit Medical Center/Wayne State University Detroit, MI
Introduction: There is a rise in colorectal cancer (CRC) in younger patients less than 45 years of age. However, there is limited data on the prevalence of colorectal neoplasia in patients younger than 45 years. Our study’s objective was to evaluate the adenoma positivity rate (APR) for patients 40-49 years undergoing colonoscopy regardless of indication
Methods:
We retrospectively reviewed our endoscopy database for all patients ages 40-49 who underwent colonoscopy at our institution between January 2018 and December 2021. We analyzed patients’ demographics, BMI, indication, findings, and bowel preparation. Colonoscopies were excluded if the bowel preparation was inadequate (n=48), or the pathology revealed colonic adenocarcinoma (n=2). Statistical analysis was performed utilizing Chi-square testing with significance set at a P < 0.05
Results: A total of 621 colonoscopies were performed for patients between 40-49 years. After applying our exclusion criteria, 571 colonoscopies were analyzed. The overall APR was 31.2%, with no statistically significant difference between patients ages 40-44 and 45-49 years (34.9% and 30.3%, p=0.358). There was no statistically significant difference in the demographics between patients with adenomas and those without adenomas detected on colonoscopy, Table 1. Most of our patients identified their race as African American (73.6%), with an overall mean BMI of 33.2, and a slightly higher percentage were females (56.2). The indication for colonoscopy showed numeric differences that were not statistically significant, with the highest APR found in patients undergoing surveillance colonoscopy for a history of colon polyps compared to average-risk screening (42.6% vs 28.2%, p=0.167)
Discussion: Our analysis of a relatively young patient population undergoing colonoscopy in an open-access colonoscopy suite, serving an urban community revealed an APR that is above 30% with no difference among patients 40-44 and 45-49 years old. Albeit our results are skewed due to a quarter of our patients undergoing high-risk screening or surveillance colonoscopy. Further research will help identify whether this similar adenoma burden translates to higher CRC rates for this younger population and its impact on CRC screening in the future
