P0275 - Frequency of Colorectal Neoplasia in Young Onset Colorectal Cancer Does Not Warrant Shorter Surveillance Intervals

Robin Mendelsohn, MD¹, Anne Hahn, MPH², Randze Lerie Palmaira, MPH¹, Asha R. Krishnan, BS¹, Melissa Lumish, MD¹, Mark Schattner, MD¹, Arnold Markowitz, MD¹, Emmy Ludwig, MD¹, Pari Shah, MD, MSCE¹, Delia Calo, MD¹, Ann Zauber, PhD², Andrea Cercek, MD^2
1Memorial Sloan-Kettering Cancer Center, New York, NY; ²Memorial Sloan Kettering Cancer Center, New York, NY

Introduction: The overall incidence of sporadic young-onset colorectal cancer (YO-CRC) is increasing and novel surveillance strategies have yet to be implemented. We sought to identify whether the outcomes of surveillance colonoscopies of patients with YO-CRC differ when compared to those with average onset colorectal cancer (AO-CRC) patients. If so, this will help inform the development of future surveillance guidelines for patients with YO-CRC.

Methods: YO-CRC patients (aged 18-49), and randomly selected AO-CRC patients (aged >/=50) at Memorial Sloan Kettering Cancer Center with at least one recorded surveillance colonoscopy occurring between 01/01/2004 to 07/31/2017, were retrospectively reviewed excluding cases of Lynch syndrome, Inflammatory Bowel Disease, or an adenomatous polyposis syndrome.

Results: 679 YO-CRC patients underwent 1,851 total surveillance colonoscopies, and 674 AO-CRC patients underwent 1,487 colonoscopies. Colorectal cancer was detected in 0.9% of YO-CRC patients and 1.2% of AO-CRC patients (RR: 1.34 95% CI: 0.47, 3.85) at 1st colonoscopy. Advanced neoplasia (defined as adenoma ≥ 1cm, ≥ three adenomas, villous, tubulovillous, high grade dysplasia, or adenocarcinoma on pathology) was detected in 8.5% of the YO-CRC and 13.1% of the AO-CRC (RR: 1.53 95% CI: 1.12, 2.09) at 1st colonoscopy. Based on the cumulative risk over both the first and second surveillance intervals, 1.6% of YO-CRC, and 1.5% of AO-CRC developed colorectal cancer (RR: 1.41 95% CI 0.63, 3.15). ;12.1% for the YO-CRC and 22.6% of AO-CRC developed advanced neoplasia (RR: 2.23 95% CI: 1.31, 3.79). The average time interval from the initial surgery to the first colonoscopy date was 16.1 months for YO-CRC, and 15.7 for AO-CRC. The average interval for first colonoscopy to the second was 21.4 months for YO-CRC and 25.8 months for AO-CRC.

Discussion: The incidence of colorectal cancer in surveillance colonoscopies between AO and YO CRC were equivalent, but the frequency of advanced adenomas was significantly higher in AO-CRC. Changes to surveillance colonoscopy guidelines may not be warranted in YO-CRC.


Disclosures:
Robin Mendelsohn: Exact Sciences – Advisory Committee/Board Member.
Anne Hahn indicated no relevant financial relationships.
Randze Lerie Palmaira indicated no relevant financial relationships.
Asha Krishnan indicated no relevant financial relationships.
Melissa Lumish indicated no relevant financial relationships.
Mark Schattner: Boston Scientific – Consultant. Novo Nordisc – Advisory Committee/Board Member.
Arnold Markowitz indicated no relevant financial relationships.
Emmy Ludwig indicated no relevant financial relationships.
Pari Shah indicated no relevant financial relationships.
Delia Calo indicated no relevant financial relationships.
Ann Zauber indicated no relevant financial relationships.
Andrea Cercek: Bayer – Advisory Committee/Board Member. GSK – Advisory Committee/Board Member. GSK – Grant/Research Support. RGenix – Grant/Research Support. Seattle Genetics – Grant/Research Support.


Robin Mendelsohn, MD¹, Anne Hahn, MPH², Randze Lerie Palmaira, MPH¹, Asha R. Krishnan, BS¹, Melissa Lumish, MD¹, Mark Schattner, MD¹, Arnold Markowitz, MD¹, Emmy Ludwig, MD¹, Pari Shah, MD, MSCE¹, Delia Calo, MD¹, Ann Zauber, PhD², Andrea Cercek, MD². P0275 - Frequency of Colorectal Neoplasia in Young Onset Colorectal Cancer Does Not Warrant Shorter Surveillance Intervals, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.