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Background
The incidence and mortality of colorectal cancer (CRC) are increasing among the young. Adenoma detection, removal and subsequent endoscopic surveillance may modify the risk of CRC before 50 years of age. This study aims to evaluate the situation of colorectal adenoma detection in Filipino patients less than 50 years of age.
Methods
This is a retrospective, descriptive study with 6211 patients less than 50 years of age who underwent colonoscopy. The endoscopy databank from January 1, 2010 until December 31, 2020 of the Institute of Digestive and Liver Diseases of St. Luke’s Medical Center Global City was used to identify cases and obtain data for this study.
Results
Overall, 6211 less than 50 years of age were included in this study. The mean age of the cohort was 43 years old; 58% were males. Family history of colorectal cancer was present in 34.8%. Asymptomatic screening was the main indication for colonoscopy.
Overall, 2103 patients (33.9%) were found to have polyps. Hyperplastic polyps were the most common (25.1%), followed by adenomas (9%). Fourteen patients who were found to have hyperplastic polyp were also found to have concomitant adenomas. Advanced neoplasm was seen in 252 patients (4.1%), with 23 of these patients having concomitant adenomas.
Polyps and advanced neoplasm were more likely seen among those aged 40–49 (60.1%). Among those with polyps in the 40–49 age group, hyperplastic polyps and adenomas were most common (42% and 14.1%, respectively). Advanced neoplasms were also most common in the 40–49 age group (14.1%).
Polyps are more frequent in males (39.3%) compared to females. Hyperplastic polyps and advanced neoplasms were likewise common in males (26.4% and 4.4%, respectively). Adenomas were more common in females (9.3%).
Conclusions
With the limitations of this study, we found that the overall prevalence of adenomas and advanced neoplasm among those aged less than 50 years to be 9% and 4.1% respectively. Increasing age and sex were associated with the development of adenomas. More research on risk factors, including whether detection, removal, and surveillance of adenomas in the young have the potential to impact early-onset colorectal cancer incidence and mortality.