C0096 - Clinical Characteristics of Young Patients With Colonic Adenomas

Monday, October 24, 2022

3:00 PM – 5:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

Mario El Hayek, MD

American University of Beirut
Gainesville, FL

Mario El Hayek, MD¹, Martine Elbejjani, PhD¹, Fadi F. Francis, MD¹, Fadi H. Mourad, MD¹, Kassem Barada, MD¹, Jana G. Hashash, MD, MSc²
¹American University of Beirut, Beirut, Beyrouth, Lebanon; ²Mayo Clinic Florida, Jacksonville, FL

Introduction: The incidence of colonic adenomas and colorectal cancer has been rising among young patients. Studies addressing the prevalence, risk factors, patient characteristics and appropriate surveillance intervals in young patients with adenomas are limited. In this study, we aim at describing the characteristics of young patients (< 50 years of age) with adenomatous polyps and characterizing those polyps.

Methods: This was a retrospective chart review of the Department of Gastroenterology database to identify patients < 50 years of age who had polyp(s) on colonoscopy done between 2008 and 2021. Patient demographics, colonoscopy indication, and number, size, location, and pathology of polyps were documented. Timing and findings of follow-up colonoscopies were recorded. Patients with personal history of inflammatory bowel disease, personal or family history of colorectal cancer were excluded.

Results: 877 patients were included in the study; mean age 42.4 ± 6.3 years, 62% males, mean BMI 27.7 ± 5.0. Colonoscopy indications were abdominal pain (26%), rectal bleeding (22%), change in bowel habits (17%), and evaluation of abnormal imaging/lab values. Of 877 patients, 610 (70%) had at least one adenoma: 571 (65%) tubular adenomas, 29 (3%) tubulovillous adenomas, 1 villous adenoma and 19 (2%) had sessile serrated adenomas. 267 (31%) patients had only hyperplastic polyps. Of patients with adenomas, 63 had a polyp > 10mm with mean polyp size 11 ± 9mm. 41% of patients had adenomas in the sigmoid, 34% in ascending, 27% in transverse, 24% in descending colon, and 22% in the rectum. Almost half (49%) of patients with adenomas were younger than 45 years and had similar demographic characteristics as patients between 45 and 50 years of age, but they had a larger mean polyp size (Table 1). Of the 610 patients with adenoma, 156 (26%) had a follow-up colonoscopy after a mean time of 2.9 ± 2.3 years, with 74 (47%) patients developing recurrent adenomas. 38 (6%) patients had a second follow-up after 2.1 ± 1.6 years and 15/38 had adenomas.

Discussion: Patients < 50 years of age with colonic adenomas were mostly males and overweight. Recurrence of adenomas was prevalent over the follow up of 3 years. For patients with GI complaints, colonoscopy should be considered in individuals with high-risk baseline characteristics. High rates of recurrent adenomas and larger polyp size in patients < 45 years of age may warrant more frequent surveillance than is done for patients > 45 years of age.

	Patients Younger than 45 Years of Age (N=299)	Patients between 45 and 50 Years of Age (N=311)	p-value
Mean Age at Colonoscopy	38.27 (n=299)	47.45 (n=311)	< 0.001
Males	58.6% (n=299)	63.0% (n=311)	0.256
BMI	26.77 (n=174)	28.20 (n=186)	0.886
Vitamin D Level	20.82 (n=161)	23.28 (n=186)	0.403
Smoking	50.0% (n=270)	51.6% (n=279)	0.705
Mean Size of Polyps	1.21 (n=109)	1.01 (n=97)	< 0.001
High Risk Patients*	24.7% (n=299)	30.2% (n=311)	0.130
Follow Up Rate	24.7% (n=299)	26.1% (n=311)	0.713

Table: * High Risk patients are defined as having three or more adenomatous polyps and/or a villous component on pathology and/or a polyp size >1cm.

Table 1: Comparison of Demographics and Polyp Characteristics between Patients Younger than 45 Years of Age and Patients 45 to 50 Years of Age with Adenomatous Polyps.

BMI: Body Mass Index.
N: Total number of patients.
n: Total number of patients used to calculate a mean or a percentage.

Disclosures:

Mario El Hayek indicated no relevant financial relationships.

Martine Elbejjani indicated no relevant financial relationships.

Fadi Francis indicated no relevant financial relationships.

Fadi Mourad indicated no relevant financial relationships.

Kassem Barada indicated no relevant financial relationships.

Jana Hashash indicated no relevant financial relationships.

Mario El Hayek, MD¹, Martine Elbejjani, PhD¹, Fadi F. Francis, MD¹, Fadi H. Mourad, MD¹, Kassem Barada, MD¹, Jana G. Hashash, MD, MSc². C0096 - Clinical Characteristics of Young Patients With Colonic Adenomas, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.