Left-Sided Dominance of Early-Onset Colorectal Cancers: A Rationale for Screening Flexible Sigmoidoscopy in the Young

Diseases of the Colon and Rectum
Lior SegevJames Church

Abstract

National databases show a recent significant increase in the incidence of colorectal cancer in people younger than 50. With current recommendations to begin average-risk screening at age 50, these patients do not have the opportunity to be screened. We hypothesized that most of the cancers among the young would be left sided, which would create an opportunity for screening the young by flexible sigmoidoscopy. This study aims to analyze the anatomic distribution of sporadic colorectal cancers in patients under the age of 50. This is a retrospective review of a prospectively maintained database. This study was conducted at a single high-volume tertiary referral center. Patients under the age of 50 with colorectal cancer between the years 2000 and 2016 were included. Patients with IBD, familial adenomatous polyposis, Lynch syndrome, or hereditary nonpolyposis colorectal cancer were excluded. The primary outcomes measured were tumor location and stage, demographics, and family history. A total of 739 patients were included. Age range at diagnosis was 18 to 49 years; median age was 44 years. Five hundred thirty patients were between the ages of 40 and 49, 167 were between the ages of 30 and 39, 40 were between the ages of 20 and 29,...Continue Reading

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Citations

Feb 4, 2019·Current Treatment Options in Gastroenterology·Anand Venugopal, Elena M Stoffel
Jun 12, 2020·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·David E KearneyMichael A Valente
Jun 5, 2019·Diseases of the Colon and Rectum·Pamela LuNelya Melnitchouk
Nov 6, 2018·Diseases of the Colon and Rectum·Hanumant ChouhanJames M Church
Apr 4, 2020·European Journal of Gastroenterology & Hepatology·Anna KrigelBenjamin Lebwohl
Feb 23, 2020·Nature Reviews. Gastroenterology & Hepatology·Lorne J HofsethFranklin G Berger
Jan 14, 2020·International Journal of Colorectal Disease·Lior SegevJames M Church
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Mar 1, 2021·BMC Gastroenterology·Kil-Yong LeeSeong Taek Oh
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Sep 25, 2020·Clinics in Colon and Rectal Surgery·Blake Read, Patricia Sylla
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