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Colorectal Polyps in Young Patients Undergoing Colonoscopy
Yuvaraj Bhusal1, Bhupendra Kumar Basnet1, Ramila Shrestha1
1National Academy for Medical Sciences, Kathmandu, Nepal.
Journal of Nepal Health Research Council
|March 18, 2025
Summary
Colorectal polyps are found in nearly a quarter of patients under 50. Early detection through colonoscopy is key, as some polyps are adenomas or adenocarcinomas, especially those larger than 5mm.
Area of Science:
- Gastroenterology
- Oncology
- Preventive Medicine
Background:
- Colorectal cancer (CRC) incidence is rising in individuals under 50.
- Colorectal polyps can progress to CRC over 5-20 years.
- Screening and polyp removal can reduce CRC progression.
Purpose of the Study:
- To determine the prevalence, distribution, and histological characteristics of colorectal polyps in patients under 50.
- To identify risk factors associated with polyp development in this age group.
Main Methods:
- A single-center, cross-sectional study included 254 consecutive patients under 50 undergoing colonoscopy.
- Exclusion criteria: prior inflammatory bowel disease, polyps, or CRC diagnosis.
- Data collected: demographics, smoking/alcohol history, polyp prevalence, location, size, and histology.
Main Results:
- Colorectal polyps were detected in 63 (24.8%) of 254 patients.
- The majority of polyps were in the recto-sigmoid region (74.6%).
- Heavy alcohol consumption and active smoking were associated with higher polyp odds. Adenomatous polyps and adenocarcinoma were found in 12 and 10 patients, respectively. Ulcerated appearance and polyp size ≥5mm significantly increased the likelihood of malignancy.
Conclusions:
- The prevalence of colorectal polyps in patients under 50 is 24.8%.
- Most polyps were benign, diminutive (<5mm), and located in the recto-sigmoid colon.
- A significant proportion (one-third) of polyps were adenomas or adenocarcinomas, highlighting the need for screening in younger populations.
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