Retrospective Cohort Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 14, 2016; 22(10): 2981-2992
Published online Mar 14, 2016. doi: 10.3748/wjg.v22.i10.2981
Characteristics of and risk factors for colorectal neoplasms in young adults in a screening population
Seung Eun Lee, Hee Bum Jo, Won Gun Kwack, Yun Jin Jeong, Yeo-Jin Yoon, Hyoun Woo Kang
Seung Eun Lee, Hee Bum Jo, Won Gun Kwack, Yun Jin Jeong, Yeo-Jin Yoon, Hyoun Woo Kang, Department of Internal Medicine, Dongguk University Ilsan Hospital, College of Medicine, Dongguk, Goyang, Gyeonggi-do 410-773, South Korea
Author contributions: Lee SE and Jo HB contributed equally to this article as first authors; Lee SE, Jo HB and Kang HW performed the data analysis and wrote the manuscript; Kang HW designed the study and supervised the entire study; Kwack WG, Jeong YJ and Yoon YJ revised the manuscript for intellectual content; all authors reviewed and approved the final version of the manuscript.
Supported by Donnguk University Research Fund 2015.
Institutional review board statement: The study was reviewed and approved by the Dongguk University Hospital Institutional Reviewer Board.
Informed consent statement: The Institutional Reviewer Board exempted the requirement for informed consent because we assessed on de-identified data retrospectively.
Conflict-of-interest statement: All the authors have no conflict of interest related to the manuscript.
Data sharing statement: The original anonymous dataset is available on request from the corresponding author at gangmali@naver.com.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Hyoun Woo Kang, MD, PhD, Department of Internal Medicine, Dongguk University Ilsan Hospital, College of Medicine, Dongguk, Goyang, Gyeonggi-do 410-773, South Korea. gangmali@naver.com
Telephone: +82-31-9617128 Fax: +82-31-9617131
Received: July 6, 2015
Peer-review started: July 8, 2015
First decision: September 29, 2015
Revised: November 3, 2015
Accepted: December 30, 2015
Article in press: December 30, 2015
Published online: March 14, 2016
Processing time: 242 Days and 19.1 Hours
Abstract

AIM: To investigate prevalence and risk factors for colorectal neoplasms in adults aged < 50 years, for whom screening is not recommended.

METHODS: This cross-sectional study compared prevalence and characteristics of colorectal and advanced adenomas in patients aged < 50 years who underwent colonoscopy screening with subjects aged ≥ 50 years. To evaluate risk factors for colorectal and advanced adenoma in young adults, we used multivariable logistic regression models. Colorectal neoplasm characteristics were evaluated and compared with those in older patients.

RESULTS: Among 2819 patients included, prevalences of colorectal adenoma and advanced adenoma were 19.7% and 1.5%, respectively. As patient age increased, so did the prevalence of colorectal neoplasm. However, prevalence of advanced adenoma did not differ between age-groups 45-49 years and ≥ 50 years (OR = 0.43, 95%CI: 0.17-1.07, P = 0.070). In younger age-group (< 50 years), colorectal adenoma was significantly associated with older age, waist circumference (OR = 1.72, 95%CI: 1.15-2.55, P = 0.008), and current smoking (OR = 1.60, 95%CI: 1.07-2.41, P = 0.023). Alcohol consumption was an independent risk factor for colorectal advanced adenoma (OR = 3.69, 95%CI: 1.08-12.54, P = 0.037). Multiple neoplasms and large neoplasms (≥ 1 cm) were more prevalent in subjects ≥ 50 years.

CONCLUSION: Current screening strategies for colorectal cancer may need to be amended to account for patient age, especially in young subjects with abdominal obesity, current smoking and alcohol consumption.

Keywords: Colorectal adenoma; Advanced adenoma; Colorectal cancer; Cancer screening; Young patients

Core tip: We investigated prevalence and risk factors for colorectal neoplasms in adults aged < 50 years. The study demonstrated that, in terms of advanced adenoma, the groups aged < 40 years and 40-44 years showed significantly lower risk compared with the group aged ≥ 50 years. However, no significant difference was found between the age-groups 45-49 years and ≥ 50 years. In the young age-group, age, waist circumference, and current smoking were associated with a higher risk of colorectal adenoma, and alcohol consumption was associated with a higher risk of advanced adenoma.