Indexed on: 19 May '16Published on: 19 May '16Published in: Journal of Gastroenterology and Hepatology
Colorectal cancer (CRC) incidence is rising among <50 year olds. The objective of this study was to determine screening colonoscopy outcomes among 40-49 year olds, which are currently limited.Asymptomatic 40-49 year olds underwent one time CRC screening colonoscopy at The Chinese University of Hong Kong between 2007-2011. Screening outcomes, including prevalence, distribution and predictive factors for overall and specifically proximal colorectal neoplasia were determined.Among 1133 ethnic Chinese, colorectal neoplasia prevalence was 20.5%. In men, distal adenomas were associated with proximal colorectal neoplasia. Men, advancing age, a first degree relative (FDR) with CRC, and diabetes mellitus were independently associated with colorectal neoplasia. A colorectal neoplasia was three times more likely to be found in a 45-49 year old man with FDR of CRC compared to a 40-44 year old woman without a FDR of CRC. The numbers needed to screen one colorectal neoplasia, and one advanced neoplasm in the highest risk group of 45-49 year old men with FDR with CRC were 2.8 (95% CI: 2.2-4.4) and 18.5 (95% CI: 8.9-39.2), respectively.Colorectal neoplasia prevalence in this 40-49 year old Chinese cohort was higher than previous studies. Men, advancing age, FDR with CRC, and diabetes mellitus can be used to risk stratify for neoplasia development. Men 45-49 years old with FDR with CRC represented the highest risk subgroup, with the lowest number needed to screen.