Advanced adenomas among young endurance runners: A prospective hypothesis-generating prevalence study

Area of Science:

• Gastroenterology
• Sports Medicine
• Oncology

Background:

• Extreme long-distance running causes gastrointestinal stress, including reduced blood flow and mucosal injury.
• The link between endurance running and colorectal neoplasia remains unclear.
• Rectal bleeding is a known post-exercise symptom in runners.

Purpose of the Study:

• To prospectively estimate the prevalence of advanced adenomas in endurance runners aged 35-50.
• To compare this prevalence with historical screening data in average-risk adults.
• To generate hypotheses regarding colorectal neoplasia risk in endurance athletes.

Main Methods:

• A prospective, single-center, cross-sectional study involving 94 endurance runners who completed at least two ultramarathons or five marathons.
• Participants underwent colonoscopy after completing a questionnaire.
• Advanced adenomas were defined by size (≥10 mm), histology (villous/tubulovillous, >25% villous), or high-grade dysplasia.

Main Results:

• Adenomas were detected in 41.5% of participants, with advanced adenomas found in 15.0% (95% CI, 8.4-23.7%).
• No colorectal cancers were detected in the study cohort.
• The prevalence of advanced adenomas appeared higher than the 1.2% historical rate in average-risk adults aged 40-49.

Conclusions:

• Advanced adenomas were found in 15.0% of the endurance runner sample.
• The observed prevalence suggests a potentially elevated risk of colorectal neoplasia in endurance runners compared to historical benchmarks.
• Further controlled studies are necessary to confirm these findings and investigate underlying mechanisms.