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Findings in young adults at colonoscopy from a hospital service database audit.
- Source :
-
BMC gastroenterology [BMC Gastroenterol] 2017 Apr 19; Vol. 17 (1), pp. 56. Date of Electronic Publication: 2017 Apr 19. - Publication Year :
- 2017
-
Abstract
- Background: Colorectal cancer (CRC) diagnosed at <50 years is predominantly located in the distal colon and rectum. Little is known about which lesion subtypes may serve as CRC precursors in young adults. The aim of this work was to document the prevalence and histological subtype of lesions seen in patients aged <50 years, and any associated clinical features.<br />Methods: An audit of the colonoscopy database at The Queen Elizabeth Hospital in Adelaide, South Australia over a 12-month period was undertaken. Findings were recorded from both colonoscopy reports and corresponding histological examination of excised lesions.<br />Results: Data were extracted from colonoscopies in 2064 patients. Those aged <50 comprised 485 (24%) of the total. CRC precursor lesions (including sessile serrated adenoma/polyps (SSA/P), traditional serrated adenomas, tubular adenomas ≥10 mm or with high-grade dysplasia, and conventional adenomas with villous histology) were seen in 4.3% of patients aged <50 and 12.9% of patients aged ≥50 (P <0.001). Among colonoscopies yielding CRC precursor lesions in patients under 50 years, SSA/P occurred in 52% of procedures (11/21), compared with 27% (55/204) of procedures in patients aged 50 and older (P = 0.02). SSA/P were proximally located in (10/11) 90% of patients aged under 50, and 80% (43/54) of those aged 50 and older (P = 0.46).<br />Conclusions: SSA/P were the most frequently observed CRC precursor lesions in patients aged <50. Most CRCs in this age group are known to arise in the distal colon and rectum suggesting that lesions other than SSA/P may serve as the precursor for the majority of early-onset CRC.
- Subjects :
- Adenoma pathology
Adolescent
Adult
Aged
Aged, 80 and over
Colon pathology
Colonic Polyps pathology
Colorectal Neoplasms pathology
Cross-Sectional Studies
Databases, Factual
Female
Gastrointestinal Hemorrhage etiology
Hospitals, Teaching
Humans
Hyperplasia
Male
Medical Audit
Middle Aged
Precancerous Conditions pathology
Rectum pathology
Risk Factors
South Australia
Young Adult
Adenoma diagnosis
Colonic Polyps diagnosis
Colonoscopy
Precancerous Conditions diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1471-230X
- Volume :
- 17
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- BMC gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 28424049
- Full Text :
- https://doi.org/10.1186/s12876-017-0612-y