Incidence and risk factors for preneoplastic and neoplastic lesions of the colon and rectum in patients under 50 referred for colonoscopy

Agazzi, Simona; Lenti, Marco Vincenzo; Klersy, Catherine; Strada, E.; Pozzi, L.; Rovedatti, L.; Bardone, M.; Costetti, Martina; Costa, Stefania; Grazia, F. De

doi:10.1016/j.ejim.2021.02.008

Cited by 8 publications

(19 citation statements)

References 35 publications

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“…In that study by Chen et al, the adenoma detection rate was found to be somewhat lower than in our study, and maybe the reason is that serrated polyp was analyzed separately from adenoma. In the Italian study by Agazzi et al, [ 27 ] age as a continuous variable was also associated with the presence of adenomas (incidence rate ratio 1.06; 95% CI, 1.03–1.09; P < .001). And, over 40 years of age was a major risk factor for both adenoma and early-onset CRC (OR 2.25; 95% CI, 1.35–3.73; P = .002).…”

Section: Discussionmentioning

confidence: 99%

Prevalence and risk of colorectal polyps among the Korean population under 50 years

et al. 2022

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Colorectal cancer is a common cancer; generally, adults aged ≥ 50 years are screened using stool occult blood tests and colonoscopy. However, colorectal adenoma and cancer have been found in patients under the aged of 50, and studies on characteristics and risk factors in young patients are lacking. We evaluated the prevalence and risk factors of colorectal adenoma and cancer in young adults aged under 50 years.We retrospectively analyzed 570 individuals aged under 50 years who underwent colonoscopy at the Haeundae Paik Hospital, Korea, from January to June 2018. Logistic regression model was used to identify the risk factors for colorectal adenoma and colorectal cancer.The prevalence of colorectal adenoma in group of 19-29 years was 3.2% (1 of 31), 30-39 years was 13.8% (30 of 217) and in the group of 40-49 years was 21.1% (68 of 322) (P = .009). In multivariable analysis, age over 45 years (adjusted odds ratio [OR], 1.941; 95% confidence interval [CI], 1.187-3.172; P = .008) and male sex (adjusted OR, 1.711; 95% CI, 1.044-2.806; P = .033) were independent risk factors for colorectal neoplasia including cancer.The prevalence of colorectal adenoma increases as the age increased in young adults under 50 years of age, especially after the age of 45 years, the risk of colorectal neoplasia increases; hence, early screening should be considered before the age of 50 years.

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Section: Discussionmentioning

confidence: 99%

Prevalence and risk of colorectal polyps among the Korean population under 50 years

et al. 2022

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“…Imperiale et al did not find any significant effect of smoking (not further specified) on eoCRC risk [ 37 ]. Agazzi and colleagues demonstrated that the smoking status was not significantly associated with either the presence of adenomas or eoCRC in a 2021 study, even accounting for bias related to pooling of eoCRC and adenomas cases [ 117 ]. In line with this, no statistically significant differences were observed between eoCRCs and healthy age and sex-matched controls in pack/year smoking among current and former smokers in the above-discussed report by Archambault et al [ 57 ].…”

Section: Smoking and Eocrcmentioning

confidence: 99%

The Role of Diet and Lifestyle in Early-Onset Colorectal Cancer: A Systematic Review

Puzzono

Mannucci

Grannò

et al. 2021

Cancers

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The incidence of early-onset colorectal cancer, defined as colorectal cancer occurring in young adults under the age of 50, is increasing globally. Knowledge of the etiological factors in young adults is far from complete. Questionable eoCRCs’ exogenous factors are represented by processed meat, sugary drinks, alcohol, Western dietary pattern, overweight and obesity, physical inactivity, and smoking, though with heterogeneous results. Therefore, we performed a systematic review to summarize the current evidence on the role of diet and lifestyle as eoCRC risk factors. We systematically searched PubMed, Scopus, and EMBASE up to July 2021, for original studies evaluating diet, alcohol, physical activity, BMI, and smoking in eoCRC and included twenty-six studies. Indeed, the exogenous factors could represent modifiable key factors, whose recognition could establish areas of future interventions through public health strategies for eoCRC primary prevention. Additionally, we discussed the role of additional non-modifiable risk factors, and of epigenetic regulation and microbiota as mediators of the eoCRC triggered by diet and lifestyle.

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“…Screening, surveillance, and treatment advances over recent years have decreased the general incidence and mortality rates of CRC in high‐income countries. In contrast, the incidence of EOCRC has alarmingly increased in 19 (mainly European and Western) countries, with reports suggesting that EOCRC accounts for 11% and 10% of all male and female CRCs, respectively 1,2 . Whilst there are minimal Australian studies investigating EOCRC incidence, a large portion of EOCRC incidence studies have used a cross‐national comparative analytical approach where Australian data has been included.…”

Section: The Incidence Of Eocrcmentioning

confidence: 99%

“…Age between 40 and 50 years, as opposed to <40 years, is one of the most significant non‐modifiable contributing factors to EOCRC development 2 . Whilst being a male has been linked to EOCRC, being a female has been reported as a protective factor for colorectal adenomas 2,8 . Inflammatory bowel disease (IBD) is a well‐established risk factor for CRC and has also been linked to EOCRC 9 .…”

Section: Established Risk Factors For Eocrcmentioning

confidence: 99%

“…Inflammatory bowel disease (IBD) is a well‐established risk factor for CRC and has also been linked to EOCRC 9 . However, in a recent EOCRC study, it was a protective factor, with authors attributing this to intense surveillance protocols 2 . A family history of CRC is also a risk factor for EOCRC, however, the proportion of EOCRC patients with a family history of CRC in published EOCRC cohorts ranged from 11.1% to 25%, which suggests that the majority of EOCRC cases are sporadic 2,9,10 .…”

Section: Established Risk Factors For Eocrcmentioning

confidence: 99%

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Early‐onset colorectal cancer: why it should be high on our list of differentials

Garrett

Steffens

Solomon

et al. 2022

ANZ Journal of Surgery

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Background: Early-onset colorectal cancer (EOCRC) (<50 years) incidence has increased in Australia and worldwide. However, the diagnosis of EOCRC is often delayed. Recent research has discovered some differences from later-onset colorectal cancer (LOCRC) (>50 years). An awareness of the unique features of EOCRC is crucial to reduce time from symptom onset to diagnosis. Methods: A literature search was conducted on electronic databases (MEDLINE, EMBASE and Cochrane Library) using the search terms "early onset colorectal cancer" or "young onset colorectal cancer." Results: The American Cancer Society has reduced the colorectal cancer screening initiation age to 45 for average-risk adults whilst screening programmes in the United Kingdom and Australia remain unchanged with initiation at 60 and 50, respectively. Exposures resulting in dysbiosis (obesity, westernised diet, alcohol, antibiotic and sugar-sweetened beverage consumption) have been linked with increased EOCRC risk. EOCRC is often leftsided presenting with rectal bleeding, altered bowel habit and constitutional symptoms. EOCRC is more commonly sporadic than hereditary, harbouring different genetic mutations than LOCRC. Comparative survival outcomes of EOCRC and LOCRC are conflicting with studies suggesting either better or poorer survival. Young patients better tolerate treatmentrelated toxicities, which may account for their improved survival despite comparatively advanced stages and poorer histopathological features at diagnosis. Conclusion: Current EOCRC literature is limited by American-focused datasets and heterogenous EOCRC definitions and study designs (the greatest strength of evidence exists for EOCRC risk factor studies comprised of large retrospective cohorts). There is minimal research into the quality of life and surgical outcomes of EOCRC patients, and this area warrants further investigation. The incidence of EOCRCScreening, surveillance, and treatment advances over recent years have decreased the general incidence and mortality rates of CRC in high-income countries. In contrast, the incidence of EOCRC has alarmingly increased in 19 (mainly European and Western) countries, with reports suggesting that EOCRC accounts for 11% and 10% of all male and female CRCs, respectively. 1,2 Whilst there are

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Incidence and risk factors for preneoplastic and neoplastic lesions of the colon and rectum in patients under 50 referred for colonoscopy

Cited by 8 publications

References 35 publications

Prevalence and risk of colorectal polyps among the Korean population under 50 years

Prevalence and risk of colorectal polyps among the Korean population under 50 years

The Role of Diet and Lifestyle in Early-Onset Colorectal Cancer: A Systematic Review

Early‐onset colorectal cancer: why it should be high on our list of differentials

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