Louis Mena, Akhtar Adeel, Ayinde Bolaji, Grabill Nathaniel, Foxhall Edward, Murdoch Emily, Sarmiento Garzon Daniel
General Surgery, Northeast Georgia Medical Center Gainesville, Gainesville, USA.
Internal Medicine, Northeast Georgia Medical Center Gainesville, Gainesville, USA.
Cureus. 2025 Feb 12;17(2):e78911. doi: 10.7759/cureus.78911. eCollection 2025 Feb.
Objective With colorectal cancer (CRC) being a leading cause of cancer-related deaths globally, early detection through screening is critical for improving survival rates. Recent guidelines recommend lowering the initial screening age from 50 to 45 years based on increasing CRC incidence among younger adults. Methodology This retrospective study evaluates the impact of this adjustment on adenoma detection rates (ADR), a validated quality indicator of screening colonoscopies. We conducted a retrospective analysis of 2,792 patients who underwent colonoscopy screening at a major healthcare institution. Patients were categorized into three age groups: 45-49, 50-59, and 60-75 years. We compared ADR across these groups with a focus on evaluating the consistency of ADR in the newly included younger age group against established benchmarks. Result The ADRs for the 45-49 age group were 51.2% (105/205) in male patients and 38.5% (116/301) in female patients, closely mirroring those of the 50-59 age group at 51.08% (188/368) in male patients and 34.80% (133/382) in female patients, with no significant reduction in detection rates. Gender-specific analysis revealed higher ADR in male patients across all age groups. These findings were statistically significant when comparing procedure type with age group and gender (p < 0.05). Conclusion The study supports maintaining the already established ADR for the new age group of 45-49 as the ADR was comparable to those in the older groups. Similar polyp biopsy +/- removal rates in the 45-49-year-old age group (43.6%; 221/506) compared to the older age group (42.7%; 320/750) is also an indirect measure of the effectiveness of early screening for colon cancer.
目的 结直肠癌（CRC）是全球癌症相关死亡的主要原因之一，通过筛查进行早期检测对于提高生存率至关重要。近期指南建议，鉴于年轻成年人中结直肠癌发病率不断上升，将初始筛查年龄从50岁降至45岁。方法 本回顾性研究评估了这一调整对腺瘤检出率（ADR）的影响，腺瘤检出率是筛查结肠镜检查的一项经过验证的质量指标。我们对一家大型医疗机构中接受结肠镜检查筛查的2792例患者进行了回顾性分析。患者被分为三个年龄组：45 - 49岁、50 - 59岁和60 - 75岁。我们比较了这些组之间的腺瘤检出率，重点评估新纳入的较年轻年龄组的腺瘤检出率与既定基准的一致性。结果 45 - 49岁年龄组男性患者的腺瘤检出率为51.2%（105/205），女性患者为38.5%（116/301），与50 - 59岁年龄组相近，该年龄组男性患者的腺瘤检出率为51.08%（188/368），女性患者为34.80%（133/382），检出率无显著降低。按性别分析显示，所有年龄组男性患者的腺瘤检出率更高。当比较检查类型与年龄组及性别时，这些结果具有统计学意义（p < 0.05）。结论 该研究支持维持45 - 49岁新年龄组已确定的腺瘤检出率，因为该年龄组的腺瘤检出率与 older groups相当。45 - 49岁年龄组的息肉活检及切除率（43.6%；221/506）与 older age group（42.7%；320/750）相近，这也是结肠癌早期筛查有效性的一项间接指标。 （注：文中“older groups”和“older age group”未明确具体所指，可能原文有误，根据语境推测为年龄较大组，但不影响整体理解。）
