Increasing incidence of early-onset colorectal precancerous lesions in patients under age 50

Medical Xpress / The Mount Sinai Hospital / Gastroenterology ^ | Jan. 11, 2022 | Steven H. Itzkowitz, MD, FACP

[ConservativeMind]

Researchers describe a troubling increase in early-onset colorectal cancer and precancerous polyps, based on a large, nationally representative study of patients under age 50 who underwent colonoscopy. It was the first large-scale study to look at precancerous polyps in this age group.

"We have known for many years that rates of colorectal cancer are rising in individuals younger than 50, prompting several medical organizations to recommend lowering the screening age from 50 to 45. What has been missing until now is confirmatory data of the prevalence of precancerous polyps in younger individuals. Because precancerous lesions are not reportable to regional or national health agencies, we have not had this degree of information to guide our recommendations. Our study provides an important piece of the puzzle and supports the recommendation changing the screening age to 45," says lead author Steven H. Itzkowitz, MD. "Our findings also suggest that messaging aimed at young individuals should begin in the years leading up to this new screening age. We know that most patients do not call their doctors on their 50th birthday to schedule a colonoscopy, so we will need to be diligent to reach this much younger cohort before they turn 45," says Dr. Itzkowitz.

Increasing age, being male and white, having a family history of colorectal cancer, and having had colonoscopies for reasons of bleeding or screening, were all associated with higher odds of advanced premalignant lesions (APLs) and colorectal cancer. Among patients aged 45-49, 32 percent had neoplasia (precancerous or cancerous lesions considered forerunners to colorectal cancer). Nearly 8 percent had APLs, and 0.58 percent had colorectal cancer.

Early-onset colorectal cancer accounts for approximately 12 percent of all colorectal cancer cases, with incidence increasing by 2.2 percent annually from 2012-2016, and mortality increasing by 1.3 percent per year from 2008-2017.

[mmichaels1970]

For diabetics, they recommend Crystal Light to mix with the prep. The only flavor you can use is their lemonade mixture, because they tell you, no red liquid.

Yeah. I went with Gatorade Zero. A bit more "non-red" sugar free flavor options there and the bottle itself is perfectly 32oz. I settled on "white" Gatorade (not sure what the flavor is). I was supposed to do 8oz every 15 minutes for an hour to equal the 32, but I just basically downed the entire thing in the first 10-15 minutes.

I think my ability to seamlessly still suck down 10 beers on trivia night with the boys made the two 32oz bottles of gatorade seem like a cake-walk.

I'm 51 I'm sure I'll be a lot less glib about it when I'm doing it in my 70s (God-willing).

[Captainpaintball]

And you’ve got to beware. The one my buddy Darryl went to was strange. Before the exam, he gave him a prostate exam. It was just Darryl and the doctor in the room. Once the doctor put in the instrument, Darryl said it felt weird, and he started to worry. But the doctor put both hands on Darrel’s shoulders and assured him everything was good. But he always thought something about that particular visit wasn’t right...

[Pelham]

There’s a known correlation between meat & fat heavy diets and colorectal cancers. Far less common among vegetarians.

Non-vegetarians can improve their chances if cruciferous vegetables and mushrooms are a standard part of their diet.

[mmichaels1970]

EVERY histology report from a colonoscopy procedure will include the words "pre-cancerous" or "atipia"

Mine said "normal", "moderate sedation" and "no specimens collected". Said to return in 10 years.

[mmichaels1970]

If you have a history of polyps or cancer in your family your doc would likely insist on a colonoscopy to get that remaining 2% covered but otherwise this test is the way to go.

I share your opinion.

[Pelham]

Exact Sciences should offer us a gift for touting their test. We shouldn’t have to work for free.

[mass55th]

"A bit more "non-red" sugar free flavor options there and the bottle itself is perfectly 32oz."

I had to mix the Crystal Light with 64 ounces of water. The prep my doctors uses requires you to drink 64 ounces, not 32.

[mmichaels1970]

Exact Sciences should offer us a gift for touting their test. We shouldn’t have to work for free.

Lol...Not sure I'm interested in any "free samples" from them.

[mmichaels1970]

The prep my doctors uses requires you to drink 64 ounces, not 32.

I had to do two bottles totaling 64oz. 32 at 6pm the night before and 32 4 hours prior to the procedure. I think each 32oz bottle had about 4 1/4 oz of Miralax. My grandson kicked in and lent me his baby-bottle to measure the Miralax.

[Pelham]

Yeah we may want to tout some other kind of test before begging for free samples.

[Valpal1]

GMO crops, especially BT crops reduces cancers of the intestinal tract by reducing exposure to aflatoxin contamination caused by fungal pests, not to mention the reduced amount of pesticide uses in general.

You know the real cause of colorectal cancer they aren’t talking about is anal sex, which our pornified younger generations are practicing at a much higher rate than older generations (both men and women). I feel so sorry for them, frankly, they are being physically, mentally and spiritually damaged by the sick internet culture they immerse themselves in.

[mass55th]

"My grandson kicked in and lent me his baby-bottle to measure the Miralax."

My sons are in their 50's, and thankfully at 74, I don't have any grandkids to worry about growing up in what will soon be a communist 3rd world shit hole.

[mmichaels1970]

I don't have any grandkids to worry about growing up in what will soon be a communist 3rd world shit hole.

I hear that and do have those concerns. Although feeling his cheek against mine does tend to make communism (and all other stress and worries) completely disappear if only for a few seconds.

[BobL]

The last time that I ran the numbers, the probability of finding something (in an otherwise healthy person with no family history) was roughly the same as an ‘accident’ happening during the procedure (roughly 1% for both).

So, no thanks, I’ll play the odds here.

[mass55th]

I hope you are able to enjoy him for many, many years, and that he has a long and happy, healthy, and fulfilling life.

[steve86]

No, I would splash myself if I were in that predicament.

[telescope115]

You don’t want one with NO sedation. Trust me on that.

[mmichaels1970]

Thank you and God Bless!

[DannyTN]

I was putting off the colonoscopy and my doctor recommended
the Cologuard test.
They send you a kit.
And you mail off some poop.
They test it and can tell if there are precancerous lesions.

Insurance covers it. But I read that if it comes back positive, mine was negative, a colonoscopy is then required.
And it shifts the colonoscopy from being preventative to diagnostic and that can change insurance reimbursement, making the colonoscopy more expensive.

[telescope115]

Yeah, I had a sigmoidoscopy once, where they use a shorter scope with no sedation, and brother, THAT hurt.