Beginning Age for Screening Colonoscopy: A Quality Assurance Assessment

Overholt, Gene; Brooks-Belli, Linda; Grace, Michael; Turyk, Mary E.; Harrell, Royce; Rankin, Kristin; Barish, Robert W.; Gilinsky, Norman H.; Rosenberg, Fred

doi:10.14309/00000434-200910003-01107

Cited by 1 publication

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“…20-26, 28-32, 34, 35, 41-43, 45, 46 . Of the 19 studies of patients undergoing colonoscopy, 7 studies were performed on symptomatic patients alone 20,21,23,30,32,41,43 , 6 on asymptomatic patients 22,28,31,34,43,47 , and 6 did not specify whether patients were symptomatic or not 24,26,29,35,42,45 . The time period for assessment of our outcome data ranged from 1972 to 2017, with 19 of them conducted in patients undergoing colonoscopy after the year 1995, 3 studies prior to 1995, and 2 that began prior to 1995, but continued past this time.…”

Section: Literature Reviewmentioning

confidence: 99%

Systematic Review of Prevalence, Risk Factors, and Risk for Metachronous Advanced Neoplasia in Patients With Young-Onset Colorectal Adenoma

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Cho

Demb

et al. 2021

Clinical Gastroenterology and Hepatology

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BACKGROUND AND AIMS: Incidence and mortality from early onset colorectal cancer (CRC) is rising. Adenoma detection, removal and subsequent endoscopic surveillance may modify risk of CRC diagnosed prior to age 50 (early onset CRC). We conducted a systematic review of young onset adenoma (YOA) prevalence, associated risk factors, and rate of metachronous advanced neoplasia after YOA diagnosis. METHODS:Through a systematic search of multiple electronic databases through 2/12/2019, we identified studies with individuals age 18 to 49 years which reported on prevalence of adenoma, risk factors for adenoma, and/or risk for metachronous advanced neoplasia. Summary estimates were derived using random effects meta-analysis, when feasible. RESULTS:Pooled overall prevalence of YOA was 9.0% (95% CI: 7.1%-11.4%) based on 24 studies including 23,142 individuals. On subgroup analysis, pooled prevalence of YOA for autopsy studies was 3.9% (95% CI: 1.9%-7.6%), while prevalence for colonoscopy studies was 10.7% (95% CI: 8.5%-13.5). Only advancing age was identified as a consistent risk factor for YOA based on 4 studies including 78,880 individuals. Pooled rate of metachronous advanced neoplasia after baseline YOA diagnosis was 6.0% (95% CI: 4.1%-8.6%), based on 3 studies including 1,493 individuals undergoing follow-up colonoscopy, with only 1 CRC case reported.Overall there were very few studies reporting metachronous advanced neoplasia, and no studies evaluating whether routine surveillance colonoscopy decreases risk of CRC. CONCLUSIONS:Prevalence of YOA is estimated to be 9% and increases with age. Risk for metachronous advanced neoplasia after YOA diagnosis is estimated to be 6%. More research is needed to understand the prevalence, risk factors, and risk of CRC associated with YOA.

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