Leong W, Guo JQ, Ning C, Luo FF, Jiao R, Yang DY. Should we perform sigmoidoscopy for colorectal cancer screening in people under 45 years? World J Gastrointest Oncol 2024; 16(4): 1248-1255 [PMID: PMC11037058 DOI: 10.4251/wjgo.v16.i4.1248]
Corresponding Author of This Article
Dong-Ye Yang, MD, PhD, Professor, Division of Gastroenterology & Hepatology, The University of Hong Kong-Shenzhen Hospital, No. 1 Haiyuan Street, Shenzhen 518053, Guangdong Province, China. yangdy@hku-szh.org
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
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/
World J Gastrointest Oncol. Apr 15, 2024; 16(4): 1248-1255 Published online Apr 15, 2024. doi: 10.4251/wjgo.v16.i4.1248
Should we perform sigmoidoscopy for colorectal cancer screening in people under 45 years?
Waiian Leong, Jia-Qi Guo, Chun Ning, Fei-Fei Luo, Rui Jiao, Dong-Ye Yang
Waiian Leong, Jia-Qi Guo, Chun Ning, Dong-Ye Yang, Division of Gastroenterology & Hepatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518053, Guangdong Province, China
Waiian Leong, Department of Accident & Emergency, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518053, Guangdong Province, China
Fei-Fei Luo, Rui Jiao, Department of Anatomical Pathology, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518053, Guangdong Province, China
Dong-Ye Yang, Endoscopy Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518053, Guangdong Province, China
Author contributions: Leong W and Yang D designed and performed the research and wrote the paper; Guo J and Ning C contributed to collect data; Leong W and Ning C contributed to analysis data; Lo F and Jiao R provided clinical advice; Yang D supervised the report.
Supported byShenzhen Science and Technology Innovation Commission Key Program of Fundamental Research, China, No. JCYJ20210324120200001; and Shenzhen Science and Technology Program of Shenzhen Clinical Research Center for Digestive Diseases, China, No. 20220822182953001.
Institutional review board statement: The need for ethics committee or institutional review board approval was not necessary because this manuscript is a retrospective observational study that is not involved any genetic testing clinical trials and unconventional clinical practice or treatments. The analysis used anonymous clinical data.
Informed consent statement: In this retrospective observational study, patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors declare that there is no conflict of interests.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dong-Ye Yang, MD, PhD, Professor, Division of Gastroenterology & Hepatology, The University of Hong Kong-Shenzhen Hospital, No. 1 Haiyuan Street, Shenzhen 518053, Guangdong Province, China. yangdy@hku-szh.org
Received: October 13, 2023 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 Processing time: 180 Days and 9.1 Hours
ARTICLE HIGHLIGHTS
Research background
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.
Research motivation
What is the better approach of CRC screening for people aged ≤ 45 years.
Research objectives
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.
Research methods
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.
Research results
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.
Research conclusions
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.
Research perspectives
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.
