P1755 - Precancerous Colonic Polyps and Colorectal Cancer in Patients Under 45 Years

Award: Presidential Poster Award

Zeina Bani Hani, MBBS¹, Leen Raddaoui, MD¹, Junseo B. Lee, MD², Reid Schalet, DO¹, Adam Jacob, DO¹, Adam Horowitz, MD¹, Giancarlo Rosa, MD¹, Nouf Turki, MD¹, Jacob T. Newman, DO³, Marie L. Borum, MD, EdD, MPH⁴, Samuel A. Schueler, MD^1
1George Washington University Hospital, Washington, DC; ²George Washington University School of Medicine and Health Sciences, Washington, DC; ³George Washington University, Washington, DC; ⁴George Washington University Medical Center, Washington, DC

Introduction: Early-onset colorectal cancer (CRC), defined as CRC diagnosis at age less than 50 years, has increased in incidence the last three decades. The most current guidelines recommend that patients start CRC screening at age 45 years if determined to be at average risk. Data on the rate of precancerous polyps, including adenomas and sessile serrated lesions (SSL), in patients under 45 years of age are limited. We sought to assess the rates of precancerous polyps and CRC among patients under 45 years of age.

Methods: We assessed colonoscopies performed in patients between the ages of 18 and 44 at our institution from November 2016 through July 2022. Patient demographics, colonoscopy indications, and endoscopic and histopathologic findings were among data recorded (Table 1). Incomplete colonoscopies, including patients with inadequate bowel preparation as defined by Boston Bowel Preparation Score (BBPS) of < 6 overall or < 2 in any colonic segment, and repeat colonoscopies in the same patient, were excluded.

Results: We identified 2159 patients between ages 18 and 44 who underwent colonoscopy. The majority of the patients were female (64%) and half were white (50%). Polyps were found in 546 patients (25%). Precancerous polyps were found on histopathology in 197 patients (8.3%). Approximately one third of patients with precancerous polyps had family history of CRC. CRC was found in 14 patients (0.6%), only one of these patients had a family history of CRC. Among 515 patients ages 40-44 years, 64 (12.4%) were found to have adenomatous polyps, and 7 were found to have SSLs (1.4%). CRC was found in 4 patients (0.8%) in this subgroup. Overall, a precancerous polyp was detected once for every 11 colonoscopies performed, and CRC was detected once for every 154 colonoscopies performed in this subgroup.

Discussion: Precancerous polyps were detected in nearly 14% of patients in our study who underwent colonoscopy between ages 40-44 years, and 8.3% of all patients under 45 who underwent colonoscopy. In light of increasing incidence of early-onset CRC, further studies are needed to evaluate precancerous polyp and CRC rates in patients under 45 years of age to further inform optimal timing to begin CRC screening.


Disclosures:


Zeina Bani Hani, MBBS¹, Leen Raddaoui, MD¹, Junseo B. Lee, MD², Reid Schalet, DO¹, Adam Jacob, DO¹, Adam Horowitz, MD¹, Giancarlo Rosa, MD¹, Nouf Turki, MD¹, Jacob T. Newman, DO³, Marie L. Borum, MD, EdD, MPH⁴, Samuel A. Schueler, MD¹. P1755 - Precancerous Colonic Polyps and Colorectal Cancer in Patients Under 45 Years, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.