Should we perform sigmoidoscopy for colorectal cancer screening in people under 45 years?  

作　　者：Waiian Leong Jia-Qi Guo Chun Ning Fei-Fei Luo Rui Jiao Dong-Ye Yang 

机构地区：[1]Division of Gastroenterology&Hepatology,The University of Hong Kong-Shenzhen Hospital,Shenzhen 518053,Guangdong Province,China [2]Department of Accident&Emergency,The University of Hong Kong-Shenzhen Hospital,Shenzhen 518053,Guangdong Province,China [3]Department of Anatomical Pathology,The University of Hong Kong-Shenzhen Hospital,Shenzhen 518053,Guangdong Province,China [4]Endoscopy Center,The University of Hong Kong-Shenzhen Hospital,Shenzhen 518053,Guangdong Province,Chin

出　　处：《World Journal of Gastrointestinal Oncology》2024年第4期1248-1255,共8页世界胃肠肿瘤学杂志（英文版）（电子版）

基　　金：Supported by Shenzhen Science and Technology Innovation Commission Key Program of Fundamental Research,China,No.JCYJ20210324120200001;Shenzhen Science and Technology Program of Shenzhen Clinical Research Center for Digestive Diseases,China,No.20220822182953001.

摘　　要：BACKGROUND The strategy for preventing colorectal cancer is screening by colonoscopy,which offers a direct way for detection and removal of adenomatous polyps(APs).American College of Gastroenterology guidelines recommend that people aged≥45 years should undergo colonoscopy;however,how to deal with people aged≤45 years is still unknown.AIM To compare the prevalence of APs and high-grade neoplasia between the left and right colon in patients≤45 years.METHODS A retrospective observational study was conducted at a single tertiary III hospital in China.This study included patients aged 18-45 years with undergoing initial colonoscopy dissection and pathological diagnosis AP or high-grade neoplasia between February 2014 and January 2021.The number of APs in the entire colon while screening and post-polypectomy surveillance in following 1-3 years were evaluated.RESULTS A total of 3053 cases were included.The prevalence of APs in the left and right colon was 55.0%and 41.6%,respectively(OR 1.7,95%CI 1.6-2.4;P<0.05).For APs with high-grade neoplasia,the prevalence was 2.7%and 0.9%,respectively(OR 3.0,95%CI 2.0-4.6;P<0.05).Therefore,the prevalence of APs and high-grade neoplasia in the left colon was significantly higher than in the right colon in patients aged≤45 years.There were 327 patients who voluntarily participated in post-polypectomy surveillance in following 1-3 years,and APs were found in 216 cases(66.1%);170 cases had 1-3 polyps(52.0%)and 46 cases had>3 polyps(14.1%;OR 0.3,95%CI 0.1-0.6;P<0.05).CONCLUSION This study suggests that flexible sigmoidoscopy would be an optimal approach for initial screening in people aged≤45 years and would be a more cost-effective and safe strategy.

关 键 词：Adenomatous polyps High-grade neoplasia COLONOSCOPY Flexible sigmoidoscopy 

分 类 号：R735.34[医药卫生—肿瘤]