caa a22 4500 445796839 CHVBK 20180317145128.0 cr unu---uuuuu 170323e20110501xx s 000 0 eng 10.1007/s10620-011-1565-6 doi (NATIONALLICENCE)springer-10.1007/s10620-011-1565-6 Detection of Colorectal Neoplasia by Colonoscopy in Average-Risk Patients Age 40-49 Versus 50-59Years [Elektronische Daten] [Matthew Thoma, Fernando Castro, Mushfeka Golawala, Ren Chen] Background: The USPSTF recommends beginning colorectal cancer screening at age 50. A recent study showed prevalence of colorectal adenomas among individuals aged 40-49 was similar to that among those aged 50-59. Aim: To assess the prevalence of colorectal neoplasia, detected during colonoscopy, by age among average-risk patients. Methods: Nine-hundred and ninety-four colonoscopies were analyzed (247 ages 40-49, 747 ages 50-59). We included consecutive patients of ages 40-59 undergoing their first colonoscopy. Colonoscopies that did not reach the cecum and patients at increased risk of colorectal cancer were excluded. The primary endpoint was the prevalence of colorectal neoplasia by age. Secondary endpoints included the prevalence of colorectal neoplasia by gender, ethnicity, and BMI. Results: The prevalence of colorectal neoplasia was 12.1% in patients aged 40-49 and 22.6% in those aged 50-59. Compared with individuals aged 40-49 there was a significantly greater prevalence of adenomas (chi-squared=12.72, P=0.0004) and of advanced adenomas or cancer (chi-squared=5.73, P=0.01) in individuals aged 50-59. After adjusting for gender, race, and BMI the effect of age remained significant (OR 0.5, 95% CI 0.33-0.76). Higher BMI was associated with increased risk of colorectal neoplasia (OR 1.03, 95% CI 1.00-1.06). The number that had to be screened to detect one advanced lesion in the 40-49 age group was 49 compared with 20 in those aged 50-59. Conclusion: Individuals aged 40-49 have a lower but measurable risk of colorectal neoplasia compared with those aged 50-59. Although there may be population subgroups for which screening below the age of 50 may be indicated, our results do not support lowering the age threshold for colonoscopy in the general population. Springer Science+Business Media, LLC, 2011 Colorectal cancer nationallicence Colonoscopy nationallicence Adenoma nationallicence Screening nationallicence Thoma Matthew Department of Gastroenterology, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd., 33331, Weston, FL, USA aut Castro Fernando Department of Gastroenterology, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd., 33331, Weston, FL, USA aut Golawala Mushfeka Department of Internal Medicine, Cleveland Clinic Florida, Weston, FL, USA aut Chen Ren College of Medicine, University of South Florida, Tampa, FL, USA aut Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/5(2011-05-01), 1503-1508 0163-2116 56:5<1503 2011 56 10620 https://doi.org/10.1007/s10620-011-1565-6 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10620-011-1565-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Thoma Matthew Department of Gastroenterology, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd., 33331, Weston, FL, USA aut NATIONALLICENCE 700 1- Castro Fernando Department of Gastroenterology, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd., 33331, Weston, FL, USA aut NATIONALLICENCE 700 1- Golawala Mushfeka Department of Internal Medicine, Cleveland Clinic Florida, Weston, FL, USA aut NATIONALLICENCE 700 1- Chen Ren College of Medicine, University of South Florida, Tampa, FL, USA aut NATIONALLICENCE 773 0- Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/5(2011-05-01), 1503-1508 0163-2116 56:5<1503 2011 56 10620 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer