Prevalence Of Colonic Neoplasia Research Articles

Age-Stratified Prevalence and Predictors of Neoplasia Among U.S. Adults Undergoing Screening Colonoscopy in a National Endoscopy Registry

Background & AimsSeveral U.S. organizations now recommend starting average-risk colorectal cancer screening at age 45 years, but the prevalence of colonic neoplasia in individuals younger than 50 years has not been well characterized. We used a national endoscopic registry to calculate age-stratified prevalence and predictors of colorectal neoplasia. MethodsOutpatient screening colonoscopies performed during 2010–2020 in the GI Quality Improvement Consortium registry were analyzed. We measured the prevalence of advanced neoplasia and adenomas by age, sex, and race/ethnicity, as well as the prevalence ratio of neoplasia compared with the reference group of 50- to 54-year-olds. Multivariable logistic regression models were used to identify predictors of neoplasia. ResultsWe identified 3,928,727 screening colonoscopies, of which 129,736 (3.3%) were performed on average-risk individuals younger than 50 years. The prevalence of advanced neoplasia was 6.2% for 50- to 54-year-olds and 5.0% (prevalence ratio, 0.81; 95% confidence interval, 0.78–0.83) for average-risk 45- to 49-year-olds. Men had higher prevalence of neoplasia than women for all age groups. White individuals had higher prevalence of advanced neoplasia than persons of other racial/ethnic groups in most age groups, which was partially driven by serrated lesions. On multivariable regression, White individuals had higher odds of advanced neoplasia than Black, Hispanic, and Asian individuals in both younger and older age groups. ConclusionsIn a large U.S. endoscopy registry, the prevalence of advanced neoplasia in 45- to 49-year-olds was substantial and supports beginning screening at age 45 years. White individuals had higher risk of advanced neoplasia than Black, Hispanic, and Asian individuals across the age spectrum. These findings may inform adenoma detection benchmarks and risk-based screening strategies.

Prevalence of colonic neoplasia and advanced lesions in the normal population: a prospective population-based colonoscopy study

Objective. There are few prospective studies of the prevalence of colonic neoplasia in the normal population. In order to properly evaluate screening-protocols for colorectal cancer in risk groups (e.g., older subjects or those with a family history), it is essential to know the prevalence of adenomas and cancer in the normal population. Methods. A prospective population-based colonoscopy study on 745 individuals born in Sweden aged 19–70 years was conducted (mean age 51.1 years). All polyps seen were retrieved and examined. Results. Out of the 745 individuals 27% had polyps, regardless of kind. Adenomas were found in 10% of the individuals and finding of adenomas was positively correlated to higher age. Men had adenomas in 15% and women in 6% of the cases. Women had a right-sided dominance of adenomas. Hyperplastic polyps were seen in 21% of the individuals. The presence of hyperplastic polyps was significantly positively correlated to the presence of adenomas. Advanced adenomas were seen in 2.8% of the study participants, but no cancers were detected. Conclusion. One in 10 healthy subjects had an adenoma but advanced adenomas were uncommon. Men and women have a different adenoma prevalence and localization. The results provide baseline European data for evaluating colonoscopy screening-protocols for colorectal cancer risk groups, and the findings may have implications for colon cancer screening in the normal, otherwise-healthy population.

Clinical predictors of colorectal polyps and carcinoma in a low prevalence region: Results of a colonoscopy based study

To estimate the prevalence of colorectal cancer (CRC) in patients with long lasting colonic symptoms undergoing total colonoscopy; and to establish clinical features predicting its occurrence. This prospective study was carried out in Imam Hospital, Tabriz University of medical sciences, Iran. Continuous patients with long lasting lower gastrointestinal tract symptoms who had the criteria of a colonoscopy were included. The endoscopist visualized the caecum documented by a photo and/or a specimen from terminal ileum. Four hundred and eighty consecutive symptomatic patients [mean age (SD): 42.73 (16.21)] were included. The prevalence of colorectal neoplasia was 15.3% (34 subjects) and 37.7% (181 subjects) had a completely normal colon. Adenomatous polyps were detected in 56 (11.7%) patients, in 12.3% of men and 10.9% of women. The mean age of the patients with a polyp was significantly higher than the others (49.53 +/- 14.16 vs 41.85 +/- 16.26, P = 0.001). Most of the adenomatous polyps were left sided and tubular; only 22.5% of polyps were more than 10 mm. Cancer was detected in 16 (3.6%) of our study population, which was mostly right sided (57.2%). The mean age of patients with cancer was significantly higher than the others (60.25 +/- 8.26 vs 42.13 +/- 16.08, P < 0.005) and higher than patients with polyps [60.25 (8.26) vs 49.53 (1.91) (P < 0.0005)]. None of the symptoms (diarrhea, abdominal pain, rectal bleeding, constipation, altering diarrhea and constipation, history of cancer, known irritable bowel disease, history of polyp and fissure or family history of cancer) were predictors for cancer or polyps, but the age of the patient and unexplained anemia independently predicted cancer. Less advanced patterns and smaller sizes of adenomas in Iran is compatible with other data from Asia and the Middle East, but in contrast to western countries. Prevalence of colonic neoplasia in our community seems to be lower than that in western population. Colonic symptoms are not predictors for polyps or cancer but unexplained anemia and elder age can predict CRC.

Prevalence of Colonic Neoplasia in Patients with a Clinical Diagnosis of Diverticulitis

Prevalence of Colonic Neoplasia in Patients with a Clinical Diagnosis of Diverticulitis Kalyani Maganti, Kent Anderson, Joseph Leung Background: Diverticulosis of the colon is common in developed countries, and the prevalence increases with age. Diverticulitis is a major clinical complication of diverticular disease affecting 10-25% of patients. Although the American College of Gastroenterology recommends elective colonoscopy after resolution of acute inflammation to exclude neoplasia, evidence for this practice guideline is lacking. This retrospective study evaluates the prevalence of colonic neoplasia in patients with a recent clinical diagnosis of diverticulitis. Because of limited resources, we determine if elective colonoscopy impacts on the outcome of this specific group of patients. Methods: We identified all patients with a diagnosis of diverticulitis by ICD-9 codes between 1996 and 2005 at our institution and those who had undergone colonoscopy within one year of the diagnosis. Patient demographics, indications, colonoscopy findings and location of significant pathology were reviewed. Primary outcomes included finding of polyps and advanced neoplasia defined as tubular adenoma O/Z 1 cm, villous histology, high grade dysplasia or cancer. Statistical analysis was performed using exact binomial 95% two-sided confidence interval. Results: A total of 16964 colonoscopies were performed during this period. 2305 patients with a ICD-9 diagnosis of diverticulitis were identified. Of these, 239 patients underwent colonoscopy within 1 year of the diagnosis. 25 patients had a poor preparation, 22 of whom had adequate examinations. Of the 236 patients, 139 were female, 97 male. Mean age was 59 years. 9 patients (3.8%) had family history of colon cancer, and 17 (7.2%) patients had history of prior colonic polyps. Significant findings on colonoscopy were 74 (31.3%) patients with polyps, 38 (16.1%) had tubular adenomas, 5 (2.1%) O10 mm. There was no cancer and no villous histology or high grade dysplasia noted on any polyps in this series. 17 patients had hyperplastic polyps. Based on analysis of our data, the probability of cancer being found at colonoscopy in this group of patients with a diagnosis of diverticulitis is !1%. Conclusions: Our data indicated that the coexistence of colonic neoplasia with diverticulitis is not significant compared to the general population. Considering the limited resources, a clinical diagnosis of uncomplicated diverticulitis in and by itself does not warrant a colonoscopy to rule out neoplasia. However, the standard screening expectations still apply.

Colonic neoplasia in asymptomatic persons with negative fecal occult blood tests: influence of age, gender, and family history.

Six hundred twenty-one asymptomatic persons with negative fecal occult blood tests (ages 50-75 yr), including 496 with no known risk factors for colorectal cancer and 125 with a single first-degree relative with a history of colonic neoplasia developed after age 40, underwent screening colonoscopy. Three Dukes A cancers were detected in average-risk persons. The overall prevalence of adenomatous polyps was 27%. Multiple logistic regression analysis revealed that increasing age and male gender were both strong predictors of colonic neoplasia (p < 0.001). A positive family history of a single first-degree relative with colorectal cancer was not associated with an increased prevalence of colonic neoplasia (p = 0.29), although an effect may be present if the relative was < 60 yr at diagnosis. Overall 16% of males and 7% of women > or = 60 yr had at least one adenoma that was large (> or = 1 cm in size), villous or tubulovillous, or had grade 3 dysplasia. We conclude that the prevalence of colonic neoplasia in asymptomatic persons with negative fecal occult blood tests is substantial, particularly in elderly males. A family history of a single first-degree relative diagnosed at age > or = 60 yr with colorectal cancer is not associated with an increased prevalence of colonic adenomas.