Profile of colorectal polyps in young patients: A retrospective study

There is an increased incidence of colorectal cancer in young patients, however, the relationship between polyp characteristics and histology is not clearly understood. This study aimed to investigate the prevalence of different histological types of polyps in young patients and risk factors associated with advanced histology. Young patients (aged <45) who underwent polypectomy at Sir Run Run Shaw Hospital (2015-2017, Zhejiang, China) and West China Xiamen Hospital (2023-2024, Xiamen, China) were included. A database of endoscopes was accessed to classify polyps according to endoscopic features. The distribution of polyps and the risk factors associated with advanced histology were reported. The detection rate of polyps among the young adults was 20%, with 47.6% of adenoma. Hyperplastic polyps were second only to tubular adenomas in frequency. Of the 2776 polyps, nearly 85% were sessile, 29.4% were located in the sigmoid colon, and 25.4% were located in the rectum. Among polyps, 87.3% were <10 mm in diameter. Histological features of advanced adenoma were found in 5.3% of patients. Of these, 30.4% occurred in polyps <10 mm. Furthermore, 69.6% were distributed in the distal colorectum. Multivariate logistic regression analysis demonstrated that polyp size and morphology were independent predictors of advanced adenomas. In young patients, polyps are mainly located in the distal colorectum, with tubular adenoma being the predominant type. Large size and pedunculated morphology were independent predictors of advanced polyp histology in young patients. Nearly one-third of the advanced histology cases were associated with small polyps. It is recommended that endoscopists resect all neoplastic polyps found during colonoscopy, especially pedunculated polyps, and submit them for histology.