Prevalence and risk factors of colorectal neoplasia in individuals aged 40–49 years: Findings from screening program in China
Mingqing Zhang
Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin, China
School of Medicine, Nankai University, Tianjin, China
Tianjin Institute of Coloproctology, Tianjin, China
The Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, China
Search for more papers by this authorYongdan Zhang
School of Medicine, Nankai University, Tianjin, China
Tianjin Institute of Coloproctology, Tianjin, China
Search for more papers by this authorWen Zhang
Center for Applied Mathematics, Tianjin University, Tianjin, China
Search for more papers by this authorYong Zhang
Center for Applied Mathematics, Tianjin University, Tianjin, China
Search for more papers by this authorLizhong Zhao
School of Medicine, Nankai University, Tianjin, China
Tianjin Institute of Coloproctology, Tianjin, China
Search for more papers by this authorHaoren Jing
School of Medicine, Nankai University, Tianjin, China
Tianjin Institute of Coloproctology, Tianjin, China
Search for more papers by this authorXinyu Gao
School of Medicine, Nankai University, Tianjin, China
Tianjin Institute of Coloproctology, Tianjin, China
Search for more papers by this authorZhenguo Nie
Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin, China
School of Medicine, Nankai University, Tianjin, China
Search for more papers by this authorCorresponding Author
Siwei Zhu
Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin, China
School of Medicine, Nankai University, Tianjin, China
Tianjin Institute of Coloproctology, Tianjin, China
The Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, China
Correspondence
Siwei Zhu, The Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, China. Email: [email protected]; Shiwu Zhang, Department of Pathology, Tianjin Union Medical Center, Tianjin 2755-7131, China. Email: [email protected]; Xipeng Zhang, Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin 2755-7131, China.
Email: [email protected]
Search for more papers by this authorCorresponding Author
Shiwu Zhang
The Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, China
Department of Pathology, Tianjin Union Medical Center, Tianjin, China
Correspondence
Siwei Zhu, The Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, China. Email: [email protected]; Shiwu Zhang, Department of Pathology, Tianjin Union Medical Center, Tianjin 2755-7131, China. Email: [email protected]; Xipeng Zhang, Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin 2755-7131, China.
Email: [email protected]
Search for more papers by this authorCorresponding Author
Xipeng Zhang
Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin, China
School of Medicine, Nankai University, Tianjin, China
Tianjin Institute of Coloproctology, Tianjin, China
The Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, China
Correspondence
Siwei Zhu, The Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, China. Email: [email protected]; Shiwu Zhang, Department of Pathology, Tianjin Union Medical Center, Tianjin 2755-7131, China. Email: [email protected]; Xipeng Zhang, Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin 2755-7131, China.
Email: [email protected]
Search for more papers by this authorMingqing Zhang
Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin, China
School of Medicine, Nankai University, Tianjin, China
Tianjin Institute of Coloproctology, Tianjin, China
The Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, China
Search for more papers by this authorYongdan Zhang
School of Medicine, Nankai University, Tianjin, China
Tianjin Institute of Coloproctology, Tianjin, China
Search for more papers by this authorWen Zhang
Center for Applied Mathematics, Tianjin University, Tianjin, China
Search for more papers by this authorYong Zhang
Center for Applied Mathematics, Tianjin University, Tianjin, China
Search for more papers by this authorLizhong Zhao
School of Medicine, Nankai University, Tianjin, China
Tianjin Institute of Coloproctology, Tianjin, China
Search for more papers by this authorHaoren Jing
School of Medicine, Nankai University, Tianjin, China
Tianjin Institute of Coloproctology, Tianjin, China
Search for more papers by this authorXinyu Gao
School of Medicine, Nankai University, Tianjin, China
Tianjin Institute of Coloproctology, Tianjin, China
Search for more papers by this authorZhenguo Nie
Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin, China
School of Medicine, Nankai University, Tianjin, China
Search for more papers by this authorCorresponding Author
Siwei Zhu
Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin, China
School of Medicine, Nankai University, Tianjin, China
Tianjin Institute of Coloproctology, Tianjin, China
The Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, China
Correspondence
Siwei Zhu, The Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, China. Email: [email protected]; Shiwu Zhang, Department of Pathology, Tianjin Union Medical Center, Tianjin 2755-7131, China. Email: [email protected]; Xipeng Zhang, Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin 2755-7131, China.
Email: [email protected]
Search for more papers by this authorCorresponding Author
Shiwu Zhang
The Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, China
Department of Pathology, Tianjin Union Medical Center, Tianjin, China
Correspondence
Siwei Zhu, The Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, China. Email: [email protected]; Shiwu Zhang, Department of Pathology, Tianjin Union Medical Center, Tianjin 2755-7131, China. Email: [email protected]; Xipeng Zhang, Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin 2755-7131, China.
Email: [email protected]
Search for more papers by this authorCorresponding Author
Xipeng Zhang
Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin, China
School of Medicine, Nankai University, Tianjin, China
Tianjin Institute of Coloproctology, Tianjin, China
The Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, China
Correspondence
Siwei Zhu, The Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, China. Email: [email protected]; Shiwu Zhang, Department of Pathology, Tianjin Union Medical Center, Tianjin 2755-7131, China. Email: [email protected]; Xipeng Zhang, Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin 2755-7131, China.
Email: [email protected]
Search for more papers by this authorDeclaration of conflict of interest: The authors disclose no conflicts. The funding source had no role in study design, data collection, analysis, or interpretation, report writing, or the decision to submit this paper for publication.
Ethics approval: Given that our study involved only a descriptive analysis of individual data without direct or indirect patient intervention, we did not require approval from a research ethics committee. Additionally, we ensured that all investigations and methods employed in the study adhered to the principles outlined in the Declaration of Helsinki.
Informed consent: Obtaining informed consent from individuals when participating in screening program.
Abstract
Background and Aim
The incidence of colorectal cancer (CRC) in individuals under 50 is increasing worldwide. We conducted an analysis of colonoscopy findings in high-risk individuals under 50 in the CRC screening program in Tianjin, China, to determine the detection rate and risk factors of advanced adenomas (AA), advanced colorectal neoplasia (ACN), colorectal neoplasia (CN).
Methods
Our study investigated individuals aged 40–49 who underwent CRC screening and completed colonoscopy, 2012–2020, while the 50–54 age group served as a control. We compared the detection rates of AA, ACN, and CN among three age groups using univariate and multivariable logistic regression analyses, and investigated the risk factors associated with AA, ACN, and CN among individuals aged 40–49.
Results
We found a gradual increase in the detection rate of AA, ACN, and CN among individuals aged 40–54. The detection rates for AA (OR 0.58; 95% CI 0.41–0.81), ACN (OR 0.58; 95% CI 0.43–0.77), and CN (OR 0.64; 95% CI 0.56–0.74) were lower in individuals aged 40–44 compared to 45–49. The detection rates of AA (OR 1.08; 95% CI 0.87–1.34) and ACN (OR 1.12; 95% CI 0.93–1.35) in individuals aged 45–49 were comparable with 50–54. Besides, lifestyle factors, BMI, and FIT are not associated with the detection rates of AA, ACN, and CN among individuals aged 40–49.
Conclusions
Our study reveals screening data in individuals under 50, indicating comparable detection rates of AA and ACN in individuals aged 45–49 and 50–54. These findings provide valuable data support for optimizing the optimal age to initiate screening.
Graphical Abstract
Open Research
Data Availability Statement
The data that support the findings of this study are available from the corresponding author upon reasonable request.
Supporting Information
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| JGH16468-sup-0001-manuscript-S.docxWord 2007 document , 347.7 KB |
Table S1. Distribution of colonoscopy-detected diseases in the 40–54 age group, n(%). Table S2. Distribution of colonoscopy-detected diseases by age group, n(%). Table S3–1. Characteristics of the age groups Before and After Propensity Score Matching, n(%). Table S3–2. Age-specific risk of AA detection, n(%). Table S3–3. Age-specific risk of ACN detection, n(%). Table S3–4. Age-specific risk of CN detection, n(%). Table S3–5. Age-specific risk of CN detection within Propensity Score Analyses, n(%). Table S4–1. Risk factors associated with the detection of AA in individuals aged 50–54 years, n(%). Table S4–2. Risk factors associated with the detection of ACN in individuals aged 50–54 years, n(%). Table S4–3. Risk factors associated with the detection of CN in individuals aged 50–54 years, n(%). Table S5–1. Risk factors associated with the detection of AA in individuals aged 40–49 years, n(%). Table S5–2. Risk factors associated with the detection of ACN in individuals aged 40–49 years, n(%). Table S5–3. Risk factors associated with the detection of CN in individuals aged 40–49 years, n(%). Table S6–1. Risk of AA detection in 40–49 age group with lifestyle and other factors included, n(%). Table S6–2. Risk of ACN detection in 40–49 age group with lifestyle and other factors included, n(%). Table S6–3. Risk of CN detection in 40–49 age group with lifestyle and other factors included, n(%). Table S6–4. Characteristics of individuals with BMI ≥ 25 or BMI<25 Before and After Propensity Score Matching, n(%). Table S6–5. Risk of AA detection in the 40–49 age group, including lifestyle and other factors through Propensity Score Analyses, n(%). Table S6–6. Risk of ACN detection in the 40–49 age group, including lifestyle and other factors through Propensity Score Analyses, n(%). Table S6–7. Risk of CN detection in the 40–49 age group, including lifestyle and other factors through Propensity Score Analyses, n(%). Table S7–1. Risk of AA detection in 50–54 age group with lifestyle and other factors included, n(%). Table S7–2. Risk of ACN detection in 50–54 age group with lifestyle and other factors included, n(%). Table S7–3. Risk of CN detection in 50–54 age group with lifestyle and other factors included, n(%). |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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