Older age at first screening colonoscopy linked to higher risk of adenomas, CRC

At a first screening colonoscopy, older patients are more likely to have a detection of adenomatous polyps and colorectal cancer (CRC), reveals a study.

A team of investigators analysed colonoscopy and histopathology data of patients with average CRC risk who had their initial screening colonoscopy between 2010 and 2017. They then determined the association between demographic variables and the risk of adenomas or CRC using univariate and multivariate logistic regression.

In total, 1,155 average risk patients (median age 54 years, 58.2 percent female) had their first screening colonoscopy during the study period.

Multivariate analysis revealed the significant association of older age at first screening with the detection of adenomatous polyps (odds ratio [OR], 1.05, 95 percent confidence interval [CI], 1.04‒1.07; p<0.001) and CRC (OR, 1.11, 95 percent CI, 1.06‒1.16; p<0.001).

The association between age and the risks of adenomatous polyps (F-test, 35.43; p=0.0019) and CRC (F-test, 36.94; p=0.0017) fit an exponential growth model. The investigators estimated a double rate of detection for every 14.20 years for adenomas and 4.75 years for CRC.

“We found that older age at the initial performance of a screening colonoscopy was associated with increased detection of adenomatous polyps and CRC,” the investigators said. “This work highlights the need for guideline adherence for the prevention of CRC development.”

Based on current guidelines, screening colonoscopy is recommended to start at 45 years of age.