Prevalence and associated factors of colorectal polyps in young adult: A Retrospective review of 302 colonoscopies data

Aims Polyps are the primary precursors to colorectal cancer and classically known to occur in patients over 50 years. However, the development of colonic polyps in patients under 50 has become an increasing concern over the past three decades as both the incidence and mortality rates of colorectal cancer have risen among this population. This study aims to study the characteristics of polyps in young adult patients and to investigate the associated factors.

Methods A retrospective study was conducted between April 2023 and October 2024 including patients aged under 50 years who underwent colonoscopy. Patients with incomplete colonoscopies were excluded. Demographic, clinical, laboratory, and endoscopic data were subsequently collected. The polyp subtype and dysplasia grading were extracted from the histopathology reports. The patients were divided into group 1: without colorectal polyps and group 2: with polyps. The two groups were compared.

Results The study included a total of 302 patients, with a male-to-female sex ratio of 1.51. The mean age was 41.13 years, ranging from 16 to 50 years. Comorbidities included diabetes in 13.2%, hypertension in 13.6%, dyslipidemia in 9.9%, and hypothyroidism in 7.6%. Metabolic syndrome was observed in 24.2% of patients. Body mass index (BMI) was assessed in 101 patients, among whom 22.87% were overweight, and 46.5% were obese. Main indications of colonoscopy were: transit disorders in 31.78%, digestive bleeding in 16.22%, abdominal bloating and pain in 19.2%, anemia in 12.2% and for screening in 6.9%. Colonic polyps were found in 32.4% of patients. The location of the polyps varied: 20.4% in the rectum, 19.4% in the sigmoid, 8.2% in the left colon, 7.1% in the transverse colon, 16.3% in the right colon, and 28.6% of patients had polyps in several locations. Polypectomy was performed using cold snare technique in 53.7%. Histopathological examination of the polyps revealed predominantly hyperplastic polyps (48.1%), tubular adenomas (46.8%), high-grade dysplastic adenomas (8.9%) and adenocarcinomas (6.3%). Statistical analyses revealed that polyps were associated with male gender (p=0.003), smoking (p=0.012), high BMI (p=0.018), family history of polyps (p=0.017), personal history of diabetes (p<0.001), dyslipidemia (p=0.031), renal insufficiency (p=0.041), metabolic syndrome (p=0.036), hepatic steatosis (p=0.004), anemia (p=0.033), hypercholesteremia (p=0.004) and hypertriglyceridemia (p=0.03).

Conclusions In our study, one young adult over three presented with colorectal polyp with identification of several associated factors. Larger studies are needed to confirm these findings in order to implement early screening and enhanced surveillance in young adults with identified risk factors to prevent colorectal cancer.

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Artikel online veröffentlicht:
27. März 2025