A new study showed marked increases in the detection of neoplasia, polyps and adenomas in colonoscopy patients aged 45 to 49 years vs. those aged 40 to 44 years.
These data, presented at UEG Week, led investigators to recommend that colorectal cancer screening should begin at age 45 years.
“These findings demonstrate that it is at 45 years old that a remarkable increase in the colorectal lesions frequency is shown, especially in the detection rate of early neoplasia,” David Karsenti, MD, of the French Society of Digestive Endoscopy, who presented the findings, said in a press release. “Even when patients with a familial and personal history of polyps or cancer are excluded from the findings, there is still a noticeable increase in detection rates in patients from the age of 45.”
Young-onset CRC is dramatically increasing, with new research showing 3 in 10 cases of CRC are diagnosed in patients younger than 55 years, according to the press release. Therefore, Karsenti and colleagues evaluated 6,027 colonoscopies from their prospective database (55% women; mean age, 57 years), to analyze polyp detection by age group.
They found that the neoplasia detection rate increased by 400% in patients aged 45 to 49 years vs. those aged 40 to 44 years, and it was also 8% higher in the group aged 45 to 49 years compared with those aged 50 to 54 years.
Further, the mean number of polyps increased by 95.8% from age 40 to 44 years vs. 45 to 49 years, and the adenoma detection rate increased by 95.4%. In comparison, the mean number of polyps increased by 19.1% from age 45 to 49 years to 50 to 54 years, and adenoma detection rate increased by 11.5%.
Even when excluding patients with familial and personal history of polyps or cancer, patients aged 45 to 49 years still showed significantly higher mean number of polyps, adenoma detection rates and neoplasia detection rates compared with patients younger than 45 years (P < .001 for all).
Neoplasia was “virtually absent” and adenoma detection rate was “very low” in patient younger than 30 years, as the investigators expected.
“Regardless of the type of screening that is in place, the results of our research strongly indicate that screening for colorectal cancer should begin at the age of 45,” Karsenti said in the press release. “This will this help us to increase the early detection of colorectal cancer in young adults and also enable the identification and safe removal of polyps that may become cancerous at a later date.” – by Adam Leitenberger
Karsenti D, et al. Abstract OP023. Presented at: UEG Week; Oct. 28-Nov. 1, 2017; Barcelona, Spain.
Disclosures: The authors report no relevant financial disclosures.