A Comparative Study on Colorectal Neoplasia Detection Rates in Average-Risk Individuals Under 50 Years of Age

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Abstract
Background/Objectives: Colonoscopy, as the modality of choice for Colorectal cancer (CRC) screening, has a well-documented impact on decreasing CRC incidence. Although starting CRC screening at the age of 50 for average-risk individuals is widely recommended, several studies suggest the need for an earlier onset. Methods: Study of 353 average-risk individuals aged 40-54 years old who underwent colonoscopy investigation. Out of the study population, 3 age groups (40-44, 45-49, and 50-54 years old) were formed. Adenoma detection rate (ADR), polyp detection rate (PDR), sessile serrated lesions detection rate (SDR), and rate of advanced colorectal neoplasia (ACRN) and colorectal cancer (CRC) were compared between the groups. Results: Comparing age groups 40-44 vs. 50-54 years old we found a statistically significant difference in terms of PDR and ADR (p-value= 0.038 and 0.045 respectively). On the contrary, no statistically significant difference was found between the age groups 45-49 and 50-54 years old, in terms of PDR, ADR, SDR, and CRC detection rate (p-value= 0.063 for PDR, 0.2 for ADR, 0.3 for SDR, >0.9 for CRC). ACRN rates were comparable between the age groups 45-49 and 50-54 years old. As for patients’ gender, males 50-54 had increased ADR and PDR in comparison with groups 40-44 and 45-49. In contrast, females bared no statistically significant difference in terms of ADR and PDR in all groups. Conclusions: Age group 45-49, sharing comparable detection rates with group 50-54, could also be considered for colorectal cancer screening.

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