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Should we perform sigmoidoscopy for colorectal cancer screening in people under 45 years?
- Source :
-
World journal of gastrointestinal oncology [World J Gastrointest Oncol] 2024 Apr 15; Vol. 16 (4), pp. 1248-1255. - Publication Year :
- 2024
-
Abstract
- Background: The strategy for preventing colorectal cancer is screening by colonoscopy, which offers a direct way for detection and removal of adenomatous polyps (APs). American College of Gastroenterology guidelines recommend that people aged ≥ 45 years should undergo colonoscopy; however, how to deal with people aged ≤ 45 years is still unknown.<br />Aim: To compare the prevalence of APs and high-grade neoplasia between the left and right colon in patients ≤ 45 years.<br />Methods: A retrospective observational study was conducted at a single tertiary III hospital in China. This study included patients aged 18-45 years with undergoing initial colonoscopy dissection and pathological diagnosis AP or high-grade neoplasia between February 2014 and January 2021. The number of APs in the entire colon while screening and post-polypectomy surveillance in following 1-3 years were evaluated.<br />Results: A total of 3053 cases were included. The prevalence of APs in the left and right colon was 55.0% and 41.6%, respectively (OR 1.7, 95%CI 1.6-2.4; P < 0.05). For APs with high-grade neoplasia, the prevalence was 2.7% and 0.9%, respectively (OR 3.0, 95%CI 2.0-4.6; P < 0.05). Therefore, the prevalence of APs and high-grade neoplasia in the left colon was significantly higher than in the right colon in patients aged ≤ 45 years. There were 327 patients who voluntarily participated in post-polypectomy surveillance in following 1-3 years, and APs were found in 216 cases (66.1%); 170 cases had 1-3 polyps (52.0%) and 46 cases had > 3 polyps (14.1%; OR 0.3, 95%CI 0.1-0.6; P < 0.05).<br />Conclusion: This study suggests that flexible sigmoidoscopy would be an optimal approach for initial screening in people aged ≤ 45 years and would be a more cost-effective and safe strategy.<br />Competing Interests: Conflict-of-interest statement: The authors declare that there is no conflict of interests.<br /> (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)
Details
- Language :
- English
- ISSN :
- 1948-5204
- Volume :
- 16
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- World journal of gastrointestinal oncology
- Publication Type :
- Academic Journal
- Accession number :
- 38660667
- Full Text :
- https://doi.org/10.4251/wjgo.v16.i4.1248