P1195 - Prevalence of Colorectal Pre-Malignant and Malignant Lesions in Patients Younger Than 50 Undergoing Colonoscopy for Any Indication

Sailaja Pisipati, MBBS, FRCS¹, Maria Aguilar, MD², Jaclyn Tuck, MBBCh, MA³, Shradha Gupta, MD⁴, Jamie Bering, MD¹, Katie L. Kunze, MA, PhD¹, Elisabeth S. Lim, MPH¹, Francisco C. Ramirez, MD, FACG¹, Jonathan A. Leighton, MD, FACG¹, N. Jewel Samadder, MD¹, Suryakanth Gurudu, MD^1
1Mayo Clinic, Scottsdale, AZ; ²University of Utah, Salt Lake City, UT; ³Mayo School of Graduate Medical Education, Scottsdale, AZ; ⁴Mayo Clinic, Chandler, AZ

Introduction: Colorectal cancer is the third leading cause of cancer death among both men and women. Incidence of colorectal neoplasia in adults younger than 50 years is increasing. It is estimated that 10.5% of new colorectal cancers occur in persons under 50 years of age. Updated USPSTF recommendations and ACS guidelines support initiating screening at age 45 years. We evaluated the prevalence of colorectal polypoid neoplastic lesions in adults younger than 50 years undergoing colonoscopy for any indication at our institution.

Methods: All persons younger than 50 years found to have polyp(s) on colonoscopy for any indication between January 2012 and December 2018 were evaluated to determine the prevalence of colorectal neoplasia including adenomas, high grade dysplasia and colorectal cancer. Demographic information, family history of colon cancer, colon polyps and hereditary cancer syndromes, presence of risk factors such as tobacco use and non-steroidal anti-inflammatory drug (NSAID) use, diabetes, hypertension and statin use was collected. Data on number of polyps, prevalence of adenomas with and without high grade dysplasia, invasive carcinoma, hyperplastic polyps and other benign pathology was evaluated.

Results: Among 1703 adults found to have a polyp(s) on colonoscopy, complete data was available for 1697 adults. Patient and polyp characteristics are included in Table 1. Mean age was 41.4 years; 49.3% were men and 50.7% women. Majority of our cohort (84.9%) were white. A total of 2897 polyps were identified. 53.3% had at least one adenoma. 56.4%, 22.7%, and 8.4% of our cohort had one, two, and three polyps respectively, and an additional 11% had > 4 polyps. A total of 46.5% of lesions were adenomas, of which 70.3% were tubular adenoma, 4.3% tubulovillous, and 25.4% sessile serrated. High grade dysplasia was noted in 0.4% and carcinoma in 0.6% of patients. Advanced adenomas (n=234) accounted for 17.4% of all the adenomas and 8.1% of our entire cohort. Hyperplastic polyps accounted for 27.2% and other benign lesions accounted for 25.4%.

Discussion: Among adults younger than 50 years of age undergoing colonoscopy for any indication and found to have a polypoid lesion, 53.3% had at least one adenoma. 46.5% of all polyps were adenomas, of which sessile serrated lesions and tubulovillous adenomas accounted for just under a third. Furthermore, the prevalence of high grade dysplasia and cancer were low at 0.4% and 0.6% respectively. Hyperplastic and other benign lesions accounted for 52.4% of polyps.



Disclosures:


Sailaja Pisipati, MBBS, FRCS¹, Maria Aguilar, MD², Jaclyn Tuck, MBBCh, MA³, Shradha Gupta, MD⁴, Jamie Bering, MD¹, Katie L. Kunze, MA, PhD¹, Elisabeth S. Lim, MPH¹, Francisco C. Ramirez, MD, FACG¹, Jonathan A. Leighton, MD, FACG¹, N. Jewel Samadder, MD¹, Suryakanth Gurudu, MD¹. P1195 - Prevalence of Colorectal Pre-Malignant and Malignant Lesions in Patients Younger Than 50 Undergoing Colonoscopy for Any Indication, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.