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首页> 外文期刊>Digestive Diseases and Sciences >Detection of colorectal neoplasia by colonoscopy in average-risk patients age 40-49 versus 50-59 years.
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Detection of colorectal neoplasia by colonoscopy in average-risk patients age 40-49 versus 50-59 years.

机译：通过结肠镜检查在40-49岁和50-59岁的平均风险患者中检测结直肠肿瘤。

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BACKGROUND: The USPSTF recommends beginning colorectal cancer screening at age 50. A recent study showed prevalence of colorectal adenomas among individuals aged 40-49 was similar to that among those aged 50-59. AIM: To assess the prevalence of colorectal neoplasia, detected during colonoscopy, by age among average-risk patients. METHODS: Nine-hundred and ninety-four colonoscopies were analyzed (247 ages 40-49, 747 ages 50-59). We included consecutive patients of ages 40-59 undergoing their first colonoscopy. Colonoscopies that did not reach the cecum and patients at increased risk of colorectal cancer were excluded. The primary endpoint was the prevalence of colorectal neoplasia by age. Secondary endpoints included the prevalence of colorectal neoplasia by gender, ethnicity, and BMI. RESULTS: The prevalence of colorectal neoplasia was 12.1% in patients aged 40-49 and 22.6% in those aged 50-59. Compared with individuals aged 40-49 there was a significantly greater prevalence of adenomas (chi-squared = 12.72, P = 0.0004) and of advanced adenomas or cancer (chi-squared = 5.73, P = 0.01) in individuals aged 50-59. After adjusting for gender, race, and BMI the effect of age remained significant (OR 0.5, 95% CI 0.33-0.76). Higher BMI was associated with increased risk of colorectal neoplasia (OR 1.03, 95% CI 1.00-1.06). The number that had to be screened to detect one advanced lesion in the 40-49 age group was 49 compared with 20 in those aged 50-59. CONCLUSION: Individuals aged 40-49 have a lower but measurable risk of colorectal neoplasia compared with those aged 50-59. Although there may be population subgroups for which screening below the age of 50 may be indicated, our results do not support lowering the age threshold for colonoscopy in the general population.
机译：背景：USPSTF建议在50岁时开始进行大肠癌筛查。最近的一项研究表明，40-49岁的人中大肠腺瘤的患病率与50-59岁的人相似。目的：评估按平均年龄划分的大肠癌在大肠镜检查中发现的结直肠癌的患病率。方法：分析了94例结肠镜检查（247例40-49岁，747例50-59岁）。我们纳入了40-59岁连续接受首次结肠镜检查的患者。排除未达到盲肠的结肠镜检查和大肠癌风险增加的患者。主要终点是按年龄分组的大肠肿瘤形成的患病率。次要研究终点包括按性别，种族和BMI划分的结直肠瘤形成患病率。结果：40-49岁的大肠癌的患病率为12.1％，50-59岁的大肠癌的患病率为22.6％。与40-49岁的个体相比，在50-59岁的个体中，腺瘤（卡方= 12.72，P = 0.0004）和晚期腺瘤或癌症（卡方= 5.73，P = 0.01）的患病率明显更高。在对性别，种族和BMI进行调整之后，年龄的影响仍然很明显（OR 0.5，95％CI 0.33-0.76）。 BMI升高与结直肠瘤形成的风险增加相关（OR 1.03，95％CI 1.00-1.06）。在40-49岁年龄组中，为筛查一种晚期病变而必须进行筛查的人数为49，而50-59岁年龄组为20。结论：与50-59岁相比，年龄在40-49岁之间的人结直肠瘤形成的风险较低，但可测量。尽管可能有某些人群需要进行低于50岁的筛查，但我们的结果并不支持降低一般人群中结肠镜检查的年龄阈值。

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