Research Finds Increase in Colonic Neoplasia Among Younger Individuals

Data from nearly 3 million colonoscopies conducted in ambulatory centers indicates rising rates of neoplasia and advanced premalignant lesions (APLs) among patients aged 18 through 54, according to a new study published online in the journal Gastroenterology.

Noting that information about the prevalence of colorectal cancer (CRC) among patients younger than 49 years of age, researchers from the Icahn School of Medicine in New York City, the Boston University School of Medicine, and Ohio State University reviewed findings from almost 3 million high-quality colonoscopies conducted at centers that report their results in the GI Quality Improvement Consortium (GIQuIC) Registry. Their goal was to identify the prevalence of colorectal neoplasia among patients aged 18 to 54 years, and to determine risk factors for CRC among this population.

“Increasing age, male sex, white race, family history of CRC, and examinations for bleeding or screening were all associated with higher odds of advanced premalignant lesions (APLs) and CRC,” the investigators wrote. “Among patients aged 45-49, 32% had any neoplasia, 7.5% had APLs, and 0.58% had CRC. Rates were almost as high in those aged 40-44. Family history of CRC portended neoplasia rates 5 years earlier.”

The team found that APLs were found at higher rates among patients of Asian, American Indian and Alaskan Native descent, but were lower among Black and Hispanic patients compared to White individuals. “The prevalence of any neoplasia and APL gradually increased between 2014-2020, in all age groups,” the authors noted.

“These data provide support for lowering the screening age to 45 for all average risk individuals. Early messaging to patients and providers in the years leading up to age 45 is warranted, especially in those with a family history of CRC,” the investigators wrote.

—Rebecca Mashaw

Reference:
Trivedi PD, Mohapatra A, Melissa, Morris MK, et al. Prevalence and predictors of young-onset colorectal neoplasia: Insights from a nationally representative colonoscopy registry. Gastroenterology. Published online January 7, 2022.