Occurrence of Colorectal Adenomas in Younger Adults: An Epidemiologic Necropsy Study

Pendergrass, Cheryl J.; Edelstein, Daniel L.; Hylind, Linda M.; Phillips, Blaine T.; Iacobuzio‐Donahue, Christine A.; Romans, Katharine; Griffin, Constance A.; Cruz‐Correa, Marcia; Tersmette, A. C.; Offerhaus, G. Johan A.; Giardiello, Francis M.

doi:10.1016/j.cgh.2008.03.022

Cited by 66 publications

(56 citation statements)

References 20 publications

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“…We suggest that the reported left-to-right shift of colonic adenomas 19,20 is partly due to recent improvements in the detection of right colonic adenomas. This is supported by results from autopsy studies, some of them from the 1980s, which demonstrate an excess of adenomas in the right colon, 23,24,26,27 some of which presumably were missed by colonoscopy in past decades. Factors which may have contributed to the high detection rate of proximal adenomas in our study are: The excellent preparation for colonoscopy and the high coecal intubation rate.…”

Section: Discussionsupporting

confidence: 60%

Distribution, size and shape of colorectal adenomas as determined by a colonoscopist with a high lesion detection rate: Influence of age, sex and colonoscopy indication

Klein

Okcu²,

Preisegger³

et al. 2015

United European Gastroenterology Journal

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Background: Increasing attention is focused on polyp-related features that may contribute to the operator-dependent nature of colonoscopy. Few data on polyps are available from high-yield colonoscopies, which may serve as a benchmark for quality control. Objectives: Describe regional distribution, histology, size and shape of polyps, and the influence of patient age and gender, in colonoscopies performed by a colonoscopist with high lesion detection rate. Methods: Analysis of 698 consecutive patients with diagnostic, screening or surveillance colonoscopies. Results: In 704 colonoscopies, 1908 polyps were removed (360 were protruded and 1548 flat; 1313 were hyperplastic, 562 adenomas, 5 serrated adenomas and 8 mixed). There were 232 adenomas in female patients and 343 in male patients; 39% of the adenomas were protruded and 61% were flat. The peak adenoma detection rate (ADR) was 51% in patients beyond age 79 years. Men older than 49 years had a higher ADR than women. In men and women, respectively: 40% and 32% of adenomas were in the right colon, 31% and 22% were in the transverse colon, and 30% and 47% were in the left colon. Beyond age 59 years, the majority of adenomas were in the proximal colon. Conclusions: An excess of adenomas in the proximal colon started at age 60 and this was more pronounced in men than in women. In all colonic regions, the majority of adenomas had a shape that was flat and smaller than 6 mm.

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Section: Discussionsupporting

confidence: 60%

Distribution, size and shape of colorectal adenomas as determined by a colonoscopist with a high lesion detection rate: Influence of age, sex and colonoscopy indication

Klein

Okcu²,

Preisegger³

et al. 2015

United European Gastroenterology Journal

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“…Colorectal polyps are most commonly located in the rectosigmoid region and exhibit a decreasing incidence towards the cecum (Pendergrass et al, 2008). In their study in a series of 914 cases, Eminler et al (2011) reported that the adenomas were localized in the rectosigmoid region at a rate of 47.…”

Section: Discussionmentioning

confidence: 97%

What are the Endoscopic and Pathological Characteristics of Colorectal Polyps?

Baş¹,

Dinc²,

Oymacı³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Background: Colon polyps need to be excised upon detection during colonoscopy due to the risk of malignancy irrespective of their size. In our study, we retrospectively evaluated the clinicopathological characteristics of polyps detected during colonoscopy. Materials and Methods: We assessed 379 patients with polyps detected during colonoscopy between January 2010 and May 2012. The demographics, complaints, colonoscopy findings (shape, place and size of the polyp) and histopathological findings were recorded. We carried out statistical analysis using PASW 18.0 for Windows. Results: There were 227 males (59.9%) and 152 females (40.1%) in the trial. The mean age was 53.8 years (32-90). The most common complaint was rectal bleeding (36.1%), followed by abdominal pain (35.4%). Polyps were detected most commonly in the rectosigmoid region (43.8%), followed by the descending colon (17.4%). Some 239 patients had a single polyp (63.1%) while 140 were found to have multiple polyps (36.9%). While tubular adenoma was the most common pathological type, occurring in 181 patients (47.8%), tubulovillous adenoma (14.2%) and hyperplastic polyp (12.7%) followed, occurring in 54 and 48 patients respectively. While 313 patients (82.6%) did not feature dysplasia, 37 patients (9.7%) exhibited lowgrade dysplasia, 28 (7.7%) had high-grade dysplasia and 4 had cancer (1.1%). The rates of villous components and dysplasia were detected to be high among pedunculated polyps and polyps larger than 1 cm (p<0.001). Conclusions: Due to the fact that large-diameter polyps with malignant potential are commonly located in the left colon and have a high prevalence among the middle-aged individuals, it would be appropriate to screen this population at regular intervals via rectosigmoidoscopy.

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“…In asymptomatic people, the prevalence of colorectal adenomas is about 25% to 30% at age 50 (21)(22)(23). Prevalence of colorectal adenomas increases with age, especially over the age of 50 (24). It has been discovered in autopsies that the prevalence of colorectal adenomas was 50% at age 70 (24).…”

Section: Discussionmentioning

confidence: 99%

“…Prevalence of colorectal adenomas increases with age, especially over the age of 50 (24). It has been discovered in autopsies that the prevalence of colorectal adenomas was 50% at age 70 (24). Most polyps are located in the left colon (24).…”

Section: Discussionmentioning

confidence: 99%

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Analysis of 2222 colorectal polyps in 896 patients: A tertiary referreal hospital study

Solakoğlu

Atalay²,

Köseoğlu³

et al. 2014

Turk J Gastroenterol

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Background/Aims: In Turkey, there are a limited number of studies including the characteristics of colorectal polyps, and the number of patients was too small in most of them. The aim of this study was to evaluate histological characteristics of colorectal polyps that were determined by colonoscopy and clinical features of patients who had removal of the polyp. Materials and Methods: Patients who underwent colonoscopy were analyzed retrospectively from January 2007 to December 2011. Adult patients (≥18 years) with no history of previous colorectal neoplasms who had removal of colorectal polyp were included. Results: A total of 2222 colorectal polyps were removed in 896 patients. Of these, 621 were male (69.3%) and 275 were female (30.7%). Most of the patients with polyps presented in the age group of 50-59 years (251 patients, 28%). It was recorded that 1816 (81.7%) of all polyps were adenomas. Of 1816 adenomas, 1577 (86.8%) were tubular adenomas. Of patients with adenomas, 19.7% was younger than 50 years. A total of 337 (37.6%) patients were in the high-risk group. Mean age of the high-risk patients was higher than the others (62±13 years and 58±13 years, respectively, p=0.001). Conclusion: This study is the largest series of colorectal polyps in Turkey to date. We determined the clinical and histologic characteristics of colorectal polyps and consider that the detection rate of colorectal adenomas in patients under the age of 50 years may be increased by the widespread use of colonoscopy as a diagnostic test.

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Occurrence of Colorectal Adenomas in Younger Adults: An Epidemiologic Necropsy Study

Abstract: Background and Aims-The colorectal adenoma is the precursor lesion in virtually all colorectal cancers. Occurrence of colorectal adenomas has been studied in older adults but analysis in younger adults is lacking.

Cited by 66 publications

References 20 publications

Distribution, size and shape of colorectal adenomas as determined by a colonoscopist with a high lesion detection rate: Influence of age, sex and colonoscopy indication

Distribution, size and shape of colorectal adenomas as determined by a colonoscopist with a high lesion detection rate: Influence of age, sex and colonoscopy indication

What are the Endoscopic and Pathological Characteristics of Colorectal Polyps?

Analysis of 2222 colorectal polyps in 896 patients: A tertiary referreal hospital study

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