Incidence and risk factors for preneoplastic and neoplastic lesions of the colon and rectum in patients under 50 referred for colonoscopy
| Autor: | L. Pozzi, Martina Costetti, S. Agazzi, Federico De Grazia, Antonio Di Sabatino, Marco Vincenzo Lenti, Aurelio Mauro, Stefania Costa, E. Strada, Catherine Klersy, Laura Rovedatti, M. Bardone |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty Adenoma Colorectal cancer Rectum Colonoscopy Disease 030204 cardiovascular system & hematology Rate ratio Gastroenterology 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Internal Medicine medicine Humans Cumulative incidence 030212 general & internal medicine Retrospective Studies medicine.diagnostic_test business.industry Incidence (epidemiology) Incidence Middle Aged medicine.disease medicine.anatomical_structure business Colorectal Neoplasms |
| Zdroj: | European journal of internal medicine. 87 |
| ISSN: | 1879-0828 |
| Popis: | Colorectal cancer (CRC) diagnosed before the age of 50, known as early-onset CRC (eoCRC), is considered uncommon. We aimed at analysing the incidence of preneoplastic and neoplastic lesions of the colon and rectum in patients under 50 years old and to identify possible predictors Methods: We retrospectively collected data from 1778 patients under 50 years old (mean age 39.9±7.8) referred for colonoscopy between 2015-2018. Cumulative incidence of adenomas and eoCRC was assessed. Multivariable regression models were fitted Results: The cumulative incidence for adenomas was 11.0% (95% CI 9-12), while it was 1.5% (95% CI 1-2) for eoCRC (metastatic disease in 13/27 patients). Age as a continuous variable was associated with the presence of adenomas (incidence rate ratio 1.06; 95% CI 1.03-1.09; p0.001). EoCRC arose in most cases in the rectum (13/27, 48.1%). Age ≥40 was the main risk factor (OR 2.25; 95% CI 1.35-3.73; p=0.002) for both adenomas (160/196 patients, 81.6%) and eoCRC (20/27 patients, 74.1%), while smoking seemed to have no role (p=0.772). The presence of alarm symptoms was statistically significant at bivariable analysis for eoCRC only (OR 3.70; 95% CI 1.49-9.22; p=0.005), as well as having multiple gastrointestinal symptoms (OR 19.85; 95% CI 2.64-149.42; p=0.004). Only 3/27 (11.1%) patients with eoCRC had a family history for CRC Conclusions: A high cumulative incidence rate of both adenomas and eoCRC was found, this latter occurring more common in patients aged 40-49, without apparent risk factors. The presence of alarm symptoms or multiple gastrointestinal symptoms led to a late diagnosis. |
| Databáze: | OpenAIRE |
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