Colorectal polyp distribution in relation to age: meta-analysis

Area of Science:

• Gastroenterology
• Oncology
• Public Health

Background:

• Global rise in early-onset colorectal cancer (CRC) contrasts with declining rates in Western countries.
• Limited data on polyp distribution in younger populations complicates screening strategies.
• This systematic review addresses the knowledge gap regarding polyp prevalence across age groups.

Purpose of the Study:

• To systematically review existing literature on polyp distribution in different age groups.
• To compare polyp locations (left vs. right colon) in individuals younger than 50 versus those 50 and older.
• To inform clinical practice for CRC screening and symptom evaluation in younger patients.

Main Methods:

• Comprehensive literature search across major databases (PubMed, Scopus, etc.) using keywords 'age' and 'polyp'.
• Inclusion of English-language articles detailing polyp distribution (adenomatous, advanced, sessile serrated lesions) by age.
• Definition of 'younger patients' as individuals under 50 years of age.

Main Results:

• Analysis of 24 eligible studies, with 12 included in meta-analysis.
• Younger individuals (<50) exhibited 75.9% left-sided polyps versus 61.9% in older individuals (≥50).
• Meta-analysis confirmed a significantly higher proportion of left-sided polyps in younger individuals (MD 0.06, CI 0.03-0.09; OR 0.77, CI 0.59-1.01).

Conclusions:

• Individuals under 50 years demonstrate a predilection for left-sided colonic polyps.
• This distribution mirrors that observed in early-onset colorectal cancer.
• Findings necessitate adjusted screening and diagnostic approaches for individuals under 50 presenting with symptoms.