Adenoma and advanced neoplasia detection rates increase from 45 years of age
Adenoma and advanced neoplasia detection rates increase from 45 years of age作者机构：Digestive Endoscopy Unit Clinique Paris-Bercy Digestive Endoscopy Unit Institut Gustave Roussy
出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)
年 卷 期：2019年第25卷第4期
页 面：447-456页
核心收录：
学科分类：10[医学]
主 题：Colorectal cancer Screening Adenoma detection rate Colonoscopy Cohort study
摘 要：BACKGROUND Colonoscopy is considered a valid primary screening tool for colorectal cancer(CRC). The decreasing risk of CRC observed in patients undergoing colonoscopy is correlated with the adenoma detection rate(ADR). Due to the fact that screening programs usually start from the age of 50, very few data are available on the risk of adenoma between 40 and 49 years. However, the incidence of CRC is increasing in young populations and it is not uncommon in routine practice to detect adenomas or even advanced neoplasia during colonoscopy in patients under 50 *** To compare the ADR and advanced neoplasia detection rate(ANDR) according to age in a large series of patients during routine *** All consecutive patients who were scheduled for colonoscopy were *** criteria were as follows: patients scheduled for partial colonoscopy or interventional colonoscopy(for stent insertion or stenosis dilation).Colonoscopies were performed in our unit by a team of 30 gastroenterologists in2016. We determined the ADR and ANDR in each age group in the whole population and in the population with an average risk of CRC(excluding patients with personal or family history of advanced adenoma or cancer).RESULTS6027 colonoscopies were performed in patients with a median age of 57 years(range, 15-96). The ADR and ANDR were 28.6% and 9.7%, respectively, in the whole population. When comparing patients aged 40-44(n = 382) and 45-49 years (n = 515), a strong increase in all parameters from 45 years was observed, with the ADR rising from 9.7% in patients aged 40-44 to 21.2% between 45 and 49(P 0.001) and the ANDR increasing from 3.1% in patients aged 40-44 to 6.4% in those aged 45-49 years(P 0.03). With regard to patients aged 50-54(n = 849), a statistically significant increase in the ADR and ANDR was not observed between patients aged 45-49 and those aged 50-54 years. In the population with an average risk of CRC, the ADR and ANDR were still significantly h
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