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International Journal of Colorectal Disease

, Volume 34, Issue 12, pp 2201–2204 | Cite as

Location of colorectal adenomas and serrated polyps in patients under age 50

  • Zexian Chen
  • Jiancong Hu
  • Zheyu Zheng
  • Chao Wang
  • Dezheng Lin
  • Yan Huang
  • Ping Lan
  • Xiaosheng HeEmail author
Short Communication
  • 72 Downloads

Abstract

Background

The incidence of colorectal cancer, especially located in distal colorectum, is rising markedly in young patients. Conventional adenomas and serrated polyps have been widely recognized as precursors of colorectal cancer.

Aim

To investigate the correlation of polyp feature with polyp location in patients under age 50.

Method

Patients under age 50 who had received colonoscopy were included from 2010 to 2018. Clinical data including number, location, size, and histopathology of polyps were collected. Odd ratios and 95% confidence interval of adenomas with their location were calculated.

Result

In total, 25,636 patients aged 18–49 were enrolled, among which 4485 patients had polyps, with polyp detection rate of 17.5%. A total of 2484 and 2387 patients had conventional adenomas and serrated polyps, respectively. 76.0% advanced adenomas and 69.5% ≥ 10-mm serrated polyps were located in the distal colorectum. The detection rate of advanced adenomas was higher in patients aged 45–49. Patients with adenomas especially advanced adenomas in the distal colorectum were more likely to have advanced adenoma in the proximal colon.

Conclusion

Among patients under age 50, advanced adenomas and ≥ 10-mm serrated polyps were predominantly in the distal colorectum. Advanced adenomas tended to be found in patients aged 45–49. Our results might explain the rising trend of distal colorectal cancer and emphasize the necessity for colonoscopy screening among these populations.

Keywords

Conventional adenoma Serrated polyp Colorectum Location Young patients 

Notes

Funding information

This work was supported by the National Key Research and Development Project of China, No. 2017YFC130880; and the Guangzhou Science and Technology Plan Projects (Health Medical Collaborative Innovation Program of Guangzhou), No. 201803040019.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A (2018) Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 68:394–424CrossRefGoogle Scholar
  2. 2.
    Siegel RL, Miller KD, Fedewa SA, Ahnen DJ, Meester R, Barzi A, Jemal A (2017) Colorectal cancer statistics, 2017. CA Cancer J Clin 67:177–193.  https://doi.org/10.3322/caac.21395 CrossRefGoogle Scholar
  3. 3.
    Brenner H, Kloor M, Pox CP (2014) Colorectal cancer. LANCET 383:1490–1502CrossRefGoogle Scholar
  4. 4.
    Erichsen R, Baron JA, Hamilton-Dutoit SJ, Snover DC, Torlakovic EE, Pedersen L, Froslev T, Vyberg M, Hamilton SR, Sorensen HT (2016) Increased risk of colorectal cancer development among patients with serrated polyps. Gastroenterology 150:895–902CrossRefGoogle Scholar
  5. 5.
    Snover DC (2011) Update on the serrated pathway to colorectal carcinoma. Hum Pathol 42:1–10CrossRefGoogle Scholar
  6. 6.
    Bailey CE, Hu CY, You YN, Bednarski BK, Rodriguez-Bigas MA, Skibber JM, Cantor SB, Chang GJ (2015) Increasing disparities in the age-related incidences of colon and rectal cancers in the United States, 1975-2010. JAMA Surg 150:17–22CrossRefGoogle Scholar
  7. 7.
    Peterse E, Meester R, Siegel RL, Chen JC, Dwyer A, Ahnen DJ, Smith RA, Zauber AG, Lansdorp-Vogelaar I (2018) The impact of the rising colorectal cancer incidence in young adults on the optimal age to start screening: microsimulation analysis i to inform the American Cancer Society colorectal cancer screening guideline. Cancer-Am Cancer Soc 124:2964–2973Google Scholar
  8. 8.
    Wolf A, Fontham E, Church TR, Flowers CR, Guerra CE, LaMonte SJ, Etzioni R, McKenna MT, Oeffinger KC, Shih YT, Walter LC, Andrews KS, Brawley OW, Brooks D, Fedewa SA, Manassaram-Baptiste D, Siegel RL, Wender RC, Smith RA (2018) Colorectal cancer screening for average-risk adults: 2018 guideline update from the American Cancer Society. CA Cancer J Clin 68:250–281CrossRefGoogle Scholar
  9. 9.
    Pommergaard HC, Burcharth J, Rosenberg J, Raskov H (2017) The association between location, age and advanced colorectal adenoma characteristics: a propensity-matched analysis. Scand J Gastroenterol 52:1–4CrossRefGoogle Scholar
  10. 10.
    Imperiale TF, Wagner DR, Lin CY, Larkin GN, Rogge JD, Ransohoff DF (2002) Results of screening colonoscopy among persons 40 to 49 years of age. N Engl J Med 346:1781–1785CrossRefGoogle Scholar
  11. 11.
    Imperiale TF, Wagner DR, Lin CY, Larkin GN, Rogge JD, Ransohoff DF (2000) Risk of advanced proximal neoplasms in asymptomatic adults according to the distal colorectal findings. N Engl J Med 343:169–174CrossRefGoogle Scholar
  12. 12.
    Imperiale TF, Glowinski EA, Lin-Cooper C, Ransohoff DF (2012) Tailoring colorectal cancer screening by considering risk of advanced proximal neoplasia. Am J Med 125:1181–1187CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Colorectal Surgerythe Sixth Affiliated Hospital, Sun Yat-sen UniversityGuangzhouChina
  2. 2.Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseasesthe Sixth Affiliated Hospital, Sun Yat-sen UniversityGuangzhouChina
  3. 3.Department of Pathologythe Sixth Affiliated Hospital, Sun Yat-sen UniversityGuangzhouChina

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