Published online Apr 15, 2024. doi: 10.4251/wjgo.v16.i4.1248
Peer-review started: October 13, 2023
First decision: January 5, 2024
Revised: January 19, 2024
Accepted: February 28, 2024
Article in press: February 28, 2024
Published online: April 15, 2024
Early onset colorectal cancer (CRC) has shown a steadily increasing incidence and mortality such that the updated guidelines recommend individuals aged ≥ 45 years with an average-risk of CRC undergo screening. However, whether people aged ≤ 45 years need colonoscopy screening or other tailored screening is unknown.
What is the better approach of CRC screening for people aged ≤ 45 years.
This study aimed to investigate the prevalence of adenomatous polyps (AP) and high-grade neoplasia as well as compare and find out the significant difference between the left- and right- colon in patients under 45 years.
A retrospective observational study was conducted in patients aged 18–45 years who underwent initial colonoscopy from February 2014 to January 2021 at a tertiary III hospital in China.
The prevalence of both APs and high-grade neoplasia in the left colon was significantly higher than in the right colon in people aged ≤ 45 years. The recurrence of > 3 APs was < 15% after 1–3 years follow-up.
Flexible sigmoidoscopy would be an optimal approach for the initial screening in people aged ≤ 45 years and would be a more cost-effective and safe strategy.
Further multicenter, large clinical and prospective studies are still needed to verify the results of the present study and investigate CRC in average-risk individuals aged ≤ 45 years.