National Trends in the Incidence of Sporadic Malignant Colorectal Polyps in Young Patients (20-49 Years): An 18-Year SEER Database Analysis
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View abstract on PubMed
Summary
This summary is machine-generated.Younger adults are increasingly diagnosed with sporadic malignant polyps (SMPs) before age 45. This trend supports the United States Preventive Services Task Force (USPSTF) recommendation for earlier colorectal cancer screening.
Area Of Science
- Oncology
- Gastroenterology
- Preventive Medicine
Background
- Conflicting guidelines exist for colorectal cancer screening initiation at age 45.
- The United States Preventive Services Task Force (USPSTF) updated guidelines in 2021 recommending screening at 45 due to rising young-onset colorectal cancer incidence.
- The American College of Physicians (ACP) recommends against screening average-risk individuals aged 45-49.
Purpose Of The Study
- To investigate national trends in the incidence of sporadic malignant polyps (SMPs) among individuals aged 20-49.
- To inform current screening guidelines for colorectal cancer.
Main Methods
- Analysis of the Surveillance, Epidemiology, and End Results (SEER) database from 2000-2017.
- Inclusion criteria: patients aged 20-49 with at least one malignant sporadic colorectal polyp diagnosed via colonoscopy.
Main Results
- 10,742 patients diagnosed with SMP; 42.9% were female.
- Mean age of incidence was 43.07 years.
- Nearly 50% of malignant polyps were diagnosed in individuals aged 45-49, with 25-30% in the 40-44 age group.
- An upward trend in malignant polyps was observed, with decreasing malignant villous adenomas and increasing malignant adenomas and tubulovillous adenomas.
Conclusions
- Almost half of SMPs under 50 occurred in individuals younger than the ACP's recommended screening age.
- The rising incidence of malignant polyps suggests changes in tumor biology.
- Further research and support for USPSTF guidelines recommending screening initiation at age 45 are warranted.
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