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Erschienen in:
19.03.2022 | Genetics in Gastroenterology Practice (BW Katona, Section Editor)
Incidental Young-Onset Adenomas: Sporadic Findings or Harbingers of Increased Colon Cancer Risk?
Erschienen in: Current Treatment Options in Gastroenterology | Ausgabe 2/2022
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Purpose of review
We aimed to determine whether young-onset adenomas increased the risk for colorectal cancer by determining the adenoma prevalence, risk factors associated with young-onset adenomas, as well as the need for surveillance colonoscopies in the young-adult population (age < 50).
Recent findings
By examining multiple meta-analyses and systematic review studies, we determined that while adenoma rates are lower in young adults (age < 45) compared to those > age 50, subsets of young adults are at higher risk of adenoma formation and therefore may have increased colorectal cancer risk. Therefore, surveillance colonoscopy may be beneficial for patients aged 40–49 years of age to reduce colorectal cancer risk, particularly in young-adult patients presenting with concerning symptoms, such as bright red blood per rectum, those found to have high-risk advanced adenomas, and those with risk factors associated with higher adenoma detection rates including diabetes, male gender, and metabolic syndrome.
Summary
Young adults found to have adenomas may warrant both close surveillance with colonoscopy as well as hereditary cancer risk assessment and genetic testing to identify underlying hereditary cancer syndromes.