Increased Prevalence of Advanced Adenomas in Younger Individuals Undergoing Early Screening Colonoscopy Due to a Family History
Publication Title
Gastro Hep Advances
Document Type
Article
Publication Date
4-16-2026
Keywords
oregon; Colorectal cancer; colorectal cancer screening; advanced adenomas; family history of advanced adenomas; colonoscopy; ppmc; ppmc gme
Abstract
Background and Aims
Current guidelines recommend patients with a first-degree relative (FDR) with advanced adenomas (AA) identified < 60 years old should initiate screening colonoscopy at age 40 or 10 years prior to their relative. Data on the prevalence of advanced adenomas and colorectal cancer in these patients, especially younger individuals, is lacking. This study determined the prevalence of advanced adenomas and colorectal cancer in younger individuals undergoing early screening colonoscopy due to a family history of advanced polyps.
Methods
A retrospective case-control study performed at a large community practice identified 409 patients who underwent screening colonoscopy due to a FDR with advanced polyps < 60 years old (“FH”) and 11,441 patients without a family history (“control”) who underwent a colonoscopy for abdominal pain or bowel changes between 2015 and 2023. Patients were divided into three age groups of 20-39, 40-45, and 45-49 years old for statistical analysis. The primary outcome was detection of advanced adenomas.
Results
The prevalence of advanced adenomas was greater in the FH group (n=40) compared to the control group (n=682) (9.8% vs 6.0%; P < .001). There was nearly a threefold increased risk of advanced adenomas in 20- to 39-year-old patients in the FH group compared to the control in the same age group (odds ratio 2.66 [95% CI, 1.17-5.29]).
Conclusions
A family history of AA was associated with an increased prevalence of advanced polyps in younger adults compared to a control population. Prospective research is needed to further evaluate the prevalence of AA in this population.
Keywords
Colorectal cancer colorectal cancer screening advanced adenomas family history of advanced adenomas colonoscopy
Abbreviations
FDR First-degree relatives AA Advanced adenoma FH Family history CRC Colorectal cancer IBD Inflammatory bowel disease OR Odds ratio
Area of Special Interest
Digestive Health
Area of Special Interest
Cancer
Specialty/Research Institute
Gastroenterology
Specialty/Research Institute
Oncology
Specialty/Research Institute
Graduate Medical Education
