128 Prevalence and Predictors of Adenomas in Young Adults Undergoing Diagnostic Colonoscopy in a Multicenter Midwest U.S. Cohort

Abstract

INTRODUCTION: Colorectal cancer incidence in population younger than 50 years of age is increasing in the United States. Data on prevalence of colon neoplastic polyps in young adults remains spars, especially in population <40 years of age. We aimed to identify the prevalence of adenoma, sessile serrated polyp and advanced adenoma in young adults undergoing diagnostic colonoscopy stratified by age 20–30, 31–40 and 41–49 years. METHODS: We reviewed diagnostic colonoscopies performed for lower gastrointestinal symptoms in young adult ≤49 years by 18 gastroenterologists at two institutions in the Midwest from October 2016 to April 2019. Patients with strong family history of colorectal carcinoma were excluded. RESULTS: We included 575 patients, mean age 34 (8) years, 220 (38%) were males, and mean BMI 30 (8), Table 1. Colon neoplastic polyps (adenoma and/or sessile serrated polyps) were noted in 116 (20%) patients, adenomas in 110 (19%), SSP/A in 30 (5%) patients and advanced adenoma was in 29 (5%). The prevalence of neoplastic polyps was 5% in patients <30 years of age, 24% in age 30–40, and 37% in age 40–49 years. Similar trend was noted for each of adenomas, SSP/A, and advanced adenomas (Table 2). Mix of adenoma and SSP/A were seen in 25 (4%) patients; with prevalence of 0.5% for age <30, 5.8% for age 30–40, and 7.4% for age 41–49 (Table 2). Males had a significantly higher adenoma prevalence (P < 0.001); no significant gender differences were noted in the prevalence of SSP/A (P = 0.17) (Table 3). CONCLUSION: Patients between 30 to 49 years of age undergoing diagnostic colonoscopy in US Midwest population is significantly higher than previously reported prevalence of neoplastic colon polyps. This is consistent with the reported increase in the incidence of colorectal neoplasia in this population. Therefore, a careful inspection for colon polyps is recommended during diagnostic colonoscopies in this population.