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Select group of patients might benefit from early colonoscopic screening for colorectal cancer

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Abstract

Background

Recently, the American Cancer Society made a qualified recommendation to start colorectal cancer (CRC) screening at 45 years of age in all average-risk individuals. In this study, our primary aim is to calculate the prevalence and also evaluate the predictors of increased prevalence of detected adenomas in the 40–49-year-old individuals undergoing colonoscopy.

Methods

A retrospective cross-sectional study was performed using our endoscopy database. Study subjects included all 40–49-year-old patients undergoing their first colonoscopy at our institution from January 1, 2010 to September 30, 2017. Exclusion criteria included patients who underwent colonoscopy for overt gastrointestinal bleeding, inflammatory bowel disease, a history of familial adenomatous polyposis, hereditary non-polyposis CRC. Univariate analysis and multivariate analysis were performed to identify factors associated with increased adenoma detection rate (ADR).

Results

A total of 2059 patients were included in the study, and 317 of these patients had family history (FH) of CRC. Patients with FH of CRC had significantly higher ADR (27.8% vs. 19.7%, p = 0.001) as compared to those without FH of CRC. There was no significant difference in ADR in patients between 40–44 years and 45–49 years of age (17.7% vs. 21.4%, p = 0.058). On a multivariate analysis while adjusting for multiple patient and procedural variables, FH of CRC, male sex, BMI > 30 kg/m2, chronic kidney disease, and age were associated with high ADR.

Conclusions

Our study shows that in addition to FH of CRC, age, male sex, BMI, and CKD are independent predictors of increased ADR in patients between 40 and 49 years of age.

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Acknowledgements

Don Powell, MD, MACP, AGAF provided writing assistance. He also provided critical review and help review the manuscript prior to submission.

Funding

The authors have no conflicts of interests or financial disclosures relevant to the manuscript.

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Authors and Affiliations

  1. Division of Gastroenterology & Hepatology, The University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555, USA

    Mohammad Bilal, Thanh-Truc Le & Praveen Guturu

  2. Division of Gastroenterology, Charleston Area Medical Center, West Virginia University, 3110 MacCorkle Avenue SE, Charleston, WV, 25304, USA

    Shailendra Singh

  3. Department of Internal Medicine, The University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555, USA

    Yamam Al-Saadi

Authors
  1. Mohammad Bilal
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  2. Shailendra Singh
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  3. Thanh-Truc Le
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  4. Yamam Al-Saadi
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  5. Praveen Guturu
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Contributions

MB and PG were involved in study concept and design, acquisition of data, drafting of manuscript, and supervised the study. SS was involved in statistical consulting and edited the manuscript. TTL and YA were involved in drafting manuscript.

Corresponding author

Correspondence to Praveen Guturu.

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Disclosures

Mohammad Bilal, Shailendra Singh, Thanh-Truc Le, Yamam Al-Saadi, and Praveen Guturu have no conflicts of interest or financial ties to disclose.

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Bilal, M., Singh, S., Le, TT. et al. Select group of patients might benefit from early colonoscopic screening for colorectal cancer. Surg Endosc 34, 4463–4471 (2020). https://doi.org/10.1007/s00464-019-07226-7

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  • DOI: https://doi.org/10.1007/s00464-019-07226-7

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