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Gastroenterologie
a hepatologie

Gastroenterology and Hepatology

Gastroent Hepatol 2025; 79(1): 49–53. doi: 10.48095/ccgh202549.

Risk of neoplasia according to age and sex – how to prioritize high-risk groups in colorectal cancer screening

Ivana Mikoviny Kajzrlíková Orcid.org  1, Petr Vítek2, Pavel Klvaňa1, Jan Kuchař Orcid.org  1, Jiří Platoš Orcid.org  1, Josef Chalupa Orcid.org  1

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Summary

Background: Early onset colorectal cancer (CRC; cancer in a person younger than 50 years) has increasing incidence in the last few years. Current age limit for population screening in Czech Republic is 50 years of age. Lowering the age limit is necessary, but this collides with limited capacity of endoscopy units. The aim of our study was to evaluate the risk of neoplastic lesions according to age and gender. Methods: It was an observational retrospective study conducted in a non-university hospital Frýdek-Místek between 2017 and 2023. The incidence of all neoplastic lesions was evaluated in age groups 30–34, 35–39, 40–44, 45–49, 50–54, and 55–59 years separately for men and women. Two dichotomous variables were compared using the Chi square test, where P <0.05 was considered significant. Results: During the study period, 13,352 colonoscopies were done in total (7,094 men, 6,258 women); 2,678 in patients <50 years of age, and 10,674 in patients ≥50 years. The incidence of all neoplastic lesions in each age group was always significantly higher than in the previous age group, the results are shown in the tables below in this text. As we determined the reference group of women 50–54 years of age as the group with the lowest risk of neoplastic lesions currently involved in population screening, the comparable risk of all neoplastic lesions was observed for men 45–49 years of age (P = 0.304) and also for men 40–44 years of age (P = 0.086). Women 45–49 years of age (P = 0.001) have a significantly lower risk of advanced neoplastic lesions than women 50–54 years of age. Conclusions: If we do not want to overload the capacity of endoscopy units, we should lower the age limit for population screening by age and gender groups. According to our retrospective data, the highest risk of neoplastic lesions is found in men 45–49 years of age, and after them men 40–44 years of age. Women 45–49 years of age have a significantly lower risk of CRC.

Keywords

colorectal cancer, diagnosis, screening, population groups

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Literature

1. Sung H, Ferlay J, Siegel RL et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021; 71(3): 209–249. doi: 10.3322/caac.21660.
2. SVOD. Epidemiologie zhoubných nádorů v ČR – analýzy. 2024 [online]. Dostupné z: https://www.svod.cz/.
3. Mauri G, Sartore-Bianchi A, Russo AG et al. Early-onset colorectal cancer in young individuals. Mol Oncol 2019; 13(2): 109–131. doi: 10.1002/1878-0261.12417.
4. Bailey CE, Hu CY, You YN et al. Increasing disparities in the age-related incidences of colon and rectal cancers in the United States, 1975–2010. JAMA Surg 2015; 150(1): 17–22. doi: 10.1001/jamasurg.2014.1756.
5. Zaborowski AM, Abdile A, Adamina M et al. Characteristics of early-onset vs late-onset colorectal cancer: a review. JAMA Surg 2021; 156(9): 865–874. doi: 10.1001/jamasurg.2021.2380.
6. Vuik FE, Nieuwenburg SA, Bardou M et al. Increasing incidence of colorectal cancer in young adults in Europe over the last 25 years. Gut 2019; 68(10): 1820–1826. doi: 10.1136/gutjnl-2018-317592.
7. Zhao J, Xu L, Sun J et al. Global trends in incidence, death, burden and risk factors of early-onset cancer from 1990 to 2019. BMJ Oncology 2023; 2(1): e000049. doi: 10.1136/bmjonc-2023000049.
8. Wolf AMD, Fontham ETH, Church TR et al. Colorectal cancer screening for average-risk adults: 2018 guideline update from the American Cancer Society. CA Cancer J Clin 2018; 68(4): 250–281. doi: 10.3322/caac.21457.
9. Suchánek Š, Ambrožová M, Grega T et al. Screening kolorektálního karcinomu v České republice – minulost, současnost a budoucnost. Gastroent Hepatol 2024; 78(5): 378–387. doi: 10.48095/ccgh2024378.
10. Saraiva MR, Rosa I, Claro I. Early-onset colorectal cancer: a review of current knowledge. World J Gastroenterol 2023; 29(8): 1289–1303. doi: 10.3748/wjg.v29.i8.1289.
11. Force USPST, Davidson KW, Barry MJ et al. Screening for colorectal cancer: US preventive services task force recommendation statement. JAMA 2021; 325(19): 1965–1977. doi: 10.1001/jama.2021.6238.
12. Lin JS, Perdue LA, Henrikson NB et al. Screening for colorectal cancer: updated evidence report and systematic review for the US preventive services task force. JAMA 2021; 325(19): 1978–1998. doi: 10.1001/jama.2021.4417.
13. You YN, Xing Y, Feig BW et al. Young-onset colorectal cancer: is it time to pay attention? Arch Intern Med 2012; 172(3): 287–289. doi: 10.1001/archinternmed.2011.602.
14. Rundle AG, Lebwohl B, Vogel R et al. Colonoscopic screening in average-risk individuals ages 40 to 49 vs 50 to 59 years. Gastroenterology 2008; 134(5): 1311–1315. doi: 10.1053/j.gastro.2008.02.032.
15. Kim H, Kim S, Kim S et al. Effectiveness of colonoscopy on early onset colorectal cancer incidence among persons 40–49 years. Vienna: UEG Week 2024.
16. Segev L, Kalady MF, Church JM. Left-sided dominance of early-onset colorectal cancer. A rationale for screening flexible sigmoidoscopy in the young. Dis Colon Rectum 2018; 61(8): 897–902. doi: 10.1097/DCR.0000000000001062.
17. Sinicrope FA. Increasing incidence of early-onset colorectal cancer. N Engl J Med 2022; 386(16): 1547–1558. doi: 10.1056/NEJMra2200 869.
18. Hofseth LJ, Hebert JR, Chanda A et al. Early-onset colorectal cancer: initial clues and current views. Nat Rev Gastroenterol Hepatol 2020; 17(6): 352–364. doi: 10.1038/s41575-019-0253-4.
19. O’Sullivan DE, Sutherland RL, Town S et al. Risk factors for early-onset colorectal cancer: a systematic review and meta-analysis. Clin Gastroenterol Hepatol 2022; 20(6): 1229.e5–1240.e5. doi: 10.1016/j.cgh.2021.01.037.
20. Shen J, Wu Y, Mo M et al. Risk factors associated with early-onset colorectal neoplasm in Chinese youth: a prospective population-based study. Front Oncol 2021; 11: 702322. doi: 10.3389/fonc.2021.702322.

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