Prevalence and risk of colorectal neoplasms in asymptomatic, average-risk screenees 40 to 49 years of age

Hong, Sung Noh; Kim, Jeong Hwan; Choe, Won Hyeok; Han, Hye Seung; Sung, In Kyung; Park, Hyung Seok; Shim, Chan Sup

doi:10.1016/j.gie.2010.06.022

« Previous Next »Gastrointestinal Endoscopy
Volume 72, Issue 3 , Pages 480-489, September 2010

Prevalence and risk of colorectal neoplasms in asymptomatic, average-risk screenees 40 to 49 years of age

Current affiliations: Digestive Disease Center, Department of Internal Medicine, Konkuk University School of Medicine (S.N.H., J.H.K., W.H.C., I.K.S., H.S.P., C.S.S.), Department of Health Promotion, Healthcare Center, Konkuk University Medical Center (S.N.H., C.S.S.), Medical Immunology Center, Institute of Biomedical Science and Technology (S.N.H., J.H.K.), Department of Pathology (H.S.H.), Konkuk University School of Medicine, Seoul, Republic of Korea

Received 21 February 2010; accepted 10 June 2010. published online 20 July 2010.

Background

A paucity of information exists regarding colorectal neoplasm in asymptomatic, average-risk individuals 40 to 49 years of age.

Objective

To evaluate the prevalence and risk factors of colorectal neoplasms in those in their 40s.

Design

Cross-sectional study.

Setting

Results offered to subjects of a health care provider that offers screening services as part of an employer-provided wellness program.

Patients

A consecutive series of 1761 asymptomatic, average-risk screenees 40 to 59 years of age.

Intervention

First screening colonoscopy.

Results

The prevalence of overall colorectal neoplasm in subjects of ages 40 to 44 years, 45 to 49 years, 50 to 54 years, and 55 to 59 years increased significantly with increasing age (13.7%, 20.2%, 21.0%, and 23.8%, respectively; P < .001). The prevalence of advanced adenomas in subjects of ages 40 to 44 years, 45 to 49 years, 50 to 54 years, and 55 to 59 years increased significantly with age (1.9%, 3.0%, 3.2%, and 5.9%, respectively; P = .004). Multivariate analysis of data from the 40- to 49-year age group identified an increased risk of colorectal neoplasm associated with ages 45 years and older (odds ratio [OR], 1.68; 95% CI, 1.20-2.35), male sex (OR, 1.76; 95% CI, 1.15-2.69), presence of abdominal obesity (OR, 1.57; 95% CI, 1.12-2.21), and metabolic syndrome (OR, 1.56; 95% CI, 1.03-2.35), whereas for advanced adenomas, abdominal obesity (OR, 2.37; 95% CI, 1.06-5.27) and metabolic syndrome (OR, 2.83; 95% CI, 1.23-6.53) were the independent risk factors.

Limitations

Single-center study and the cohort composed of ethnic Korean subjects who lived in the same geographic region.

Conclusion

In average-risk individuals 40 to 49 years of age, men with abdominal obesity or metabolic syndrome might benefit from screening colonoscopy starting at 45 years of age to detect colorectal neoplasm.

Abbreviations: AOR, adjusted odds ratio, CRC, colorectal cancer, MetS, metabolic syndrome, NNS, number needed to screen, OR, odds ratio