{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T23:58:43Z","timestamp":1791158323739,"version":"4.1.0"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,12,16]],"date-time":"2024-12-16T00:00:00Z","timestamp":1734307200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,12,16]],"date-time":"2024-12-16T00:00:00Z","timestamp":1734307200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100007833","name":"Hamad Medical Corporation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100007833","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Colorectal Dis"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Bleeding per rectum (BPR) is a common clinical presentation, and colonoscopy is the gold standard for evaluating patients aged\u2009\u2265\u200945\u00a0years. However, its role in younger patients remains unclear. This study evaluated the appropriateness of colonoscopy in patients\u2009&lt;\u200940\u00a0years of age who presented with BPR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective observational study was conducted over 10\u00a0years, including 3422 patients aged 18\u201340\u00a0years who underwent colonoscopy for BPR. The cohort was divided into two age groups: younger (aged 18\u201330\u00a0years) and older (31\u201340\u00a0years). The patients\u2019 baseline characteristics, colonoscopy findings, and histopathological results were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Hemorrhoids were the most common finding (48%), with a higher prevalence in younger age groups (50.7%). Polyps were detected in 12.5% of patients, with 1.75% having advanced adenoma polyps (AAP) and 1.3% diagnosed with colorectal cancer (CRC). A family history of CRC\/AAP was significantly associated with increased CRC risk (adjusted OR 6.35, 95% CI 2.24\u201318.02,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001) in explorative logistic regression analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>AAP and CRC were detected in a small but significant proportion of patients, particularly among those aged 18\u201330\u00a0years. The detection of significant lesions in this age group highlights the need for targeted colonoscopy based on specific risk factors such as family history and clinical presentation. Future research should prioritize the creation of targeted assessment models to improve clinical decision making in this context.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00384-024-04784-8","type":"journal-article","created":{"date-parts":[[2024,12,16]],"date-time":"2024-12-16T01:13:36Z","timestamp":1734311616000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Evaluating the necessity of colonoscopy in patients under 40 with rectal bleeding: insights from a large-scale retrospective analysis"],"prefix":"10.1007","volume":"39","author":[{"given":"Ibrahim M.","family":"Obeidat","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yousef","family":"Yahia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prem","family":"Chandra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amani","family":"Altaiam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ethar","family":"Mohamed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Husam","family":"Saffo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raya","family":"Abualsuod","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ala\u2019a Al-deen","family":"Mousa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duha","family":"Shalatouni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khaled","family":"Alsa\u2019ed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud Y.","family":"Arabyat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,12,16]]},"reference":[{"key":"4784_CR1","unstructured":"Sabry AO, Sood T (2023) Rectal bleeding. In: StatPearls [Internet]. StatPearls Publishing.\u00a0https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK563143\/. Accessed 6 Oct 2024"},{"key":"4784_CR2","doi-asserted-by":"publisher","first-page":"514","DOI":"10.3399\/bjgp18X699485","volume":"68","author":"CJ Walsh","year":"2018","unstructured":"Walsh CJ, Delaney S, Rowlands A (2018) Rectal bleeding in general practice: new guidance on commissioning. Br J Gen Pract 68:514\u2013515. https:\/\/doi.org\/10.3399\/bjgp18X699485","journal-title":"Br J Gen Pract"},{"key":"4784_CR3","doi-asserted-by":"publisher","first-page":"E959","DOI":"10.1055\/s-0043-117958","volume":"05","author":"K Oakland","year":"2017","unstructured":"Oakland K, Isherwood J, Lahiff C et al (2017) Diagnostic and therapeutic treatment modalities for acute lower gastrointestinal bleeding: a systematic review. Endosc Int Open 05:E959\u2013E973. https:\/\/doi.org\/10.1055\/s-0043-117958","journal-title":"Endosc Int Open"},{"key":"4784_CR4","doi-asserted-by":"publisher","first-page":"209","DOI":"10.3322\/caac.21660","volume":"71","author":"H Sung","year":"2021","unstructured":"Sung H, Ferlay J, Siegel RL et al (2021) Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 71:209\u2013249. https:\/\/doi.org\/10.3322\/caac.21660","journal-title":"CA Cancer J Clin"},{"key":"4784_CR5","doi-asserted-by":"publisher","unstructured":"Dave D, Lu R, Klair J, et al (2019) Prevalence and predictors of adenomas in young adults undergoing diagnostic colonoscopy in a multicenter Midwest U.S. cohort: 128. Am J Gastroenterol 114:S76. https:\/\/doi.org\/10.14309\/01.ajg.0000590044.42428.fc","DOI":"10.14309\/01.ajg.0000590044.42428.fc"},{"key":"4784_CR6","doi-asserted-by":"publisher","first-page":"59","DOI":"10.3238\/arztebl.m2022.0368","volume":"120","author":"LF Tanaka","year":"2023","unstructured":"Tanaka LF, Figueroa SH, Popova V et al (2023) The rising incidence of early-onset colorectal cancer. Dtsch Arztebl Int 120:59\u201364. https:\/\/doi.org\/10.3238\/arztebl.m2022.0368","journal-title":"Dtsch Arztebl Int"},{"key":"4784_CR7","doi-asserted-by":"publisher","first-page":"101174","DOI":"10.1016\/j.tranon.2021.101174","volume":"14","author":"Y Xi","year":"2021","unstructured":"Xi Y, Xu P (2021) Global colorectal cancer burden in 2020 and projections to 2040. Transl Oncol 101174. https:\/\/doi.org\/10.1016\/j.tranon.2021.101174","journal-title":"Transl Oncol"},{"key":"4784_CR8","doi-asserted-by":"publisher","first-page":"1965","DOI":"10.1001\/jama.2021.6238","volume":"325","author":"KW Davidson","year":"2021","unstructured":"US Preventive Services Task Force, Davidson KW, Barry MJ et al (2021) Screening for colorectal cancer: US Preventive Services Task Force recommendation statement. JAMA 325:1965\u20131977. https:\/\/doi.org\/10.1001\/jama.2021.6238","journal-title":"JAMA"},{"key":"4784_CR9","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.2022.220320R2","author":"AN Huffstetler","year":"2023","unstructured":"Huffstetler AN, Fraiman J, Brownlee S et al (2023) An estimate of severe harms due to screening colonoscopy: a systematic review. J Am Board Fam Med. https:\/\/doi.org\/10.3122\/jabfm.2022.220320R2","journal-title":"J Am Board Fam Med"},{"key":"4784_CR10","doi-asserted-by":"publisher","unstructured":"T C, Pk Z, Dc D (2023) The role of colonoscopy in young patients with rectal bleeding: a systematic review and meta-analysis. Int J Colorectal Dis 38. https:\/\/doi.org\/10.1007\/s00384-023-04524-4","DOI":"10.1007\/s00384-023-04524-4"},{"key":"4784_CR11","doi-asserted-by":"publisher","first-page":"466","DOI":"10.5946\/ce.2019.029","volume":"53","author":"MH Tang","year":"2020","unstructured":"Tang MH, Foo FJ, Ng CY (2020) Endoscopic findings in patients under the age of 40 years with hematochezia in Singapore. Clin Endosc 53:466\u2013470. https:\/\/doi.org\/10.5946\/ce.2019.029","journal-title":"Clin Endosc"},{"key":"4784_CR12","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1159\/000481686","volume":"4","author":"FH Koh","year":"2017","unstructured":"Koh FH, Seah A, Chan D et al (2017) Is colonoscopy indicated in young patients with hematochezia. Gastrointest Tumors 4:90\u201395. https:\/\/doi.org\/10.1159\/000481686","journal-title":"Gastrointest Tumors"},{"key":"4784_CR13","doi-asserted-by":"publisher","first-page":"692","DOI":"10.1055\/s-0030-1256356","volume":"43","author":"AB Khalid","year":"2011","unstructured":"Khalid AB, Majid S, Salih M et al (2011) Is full colonoscopic examination necessary in young patients with fresh bleeding per rectum? Endoscopy 43:692\u2013696. https:\/\/doi.org\/10.1055\/s-0030-1256356","journal-title":"Endoscopy"},{"key":"4784_CR14","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1016\/j.cgh.2019.07.016","volume":"18","author":"MCS Wong","year":"2020","unstructured":"Wong MCS, Huang J, Huang JLW et al (2020) Global prevalence of colorectal neoplasia: a systematic review and meta-analysis. Clin Gastroenterol Hepatol 18:553\u2013561.e10. https:\/\/doi.org\/10.1016\/j.cgh.2019.07.016","journal-title":"Clin Gastroenterol Hepatol"},{"key":"4784_CR15","doi-asserted-by":"publisher","first-page":"1011","DOI":"10.1158\/1055-9965.EPI-18-0030","volume":"27","author":"L Ellis","year":"2018","unstructured":"Ellis L, Abrah\u00e3o R, McKinley M et al (2018) Colorectal cancer incidence trends by age, stage, and racial\/ethnic group in California, 1990\u20132014. Cancer Epidemiol Biomarkers Prev 27:1011\u20131018. https:\/\/doi.org\/10.1158\/1055-9965.EPI-18-0030","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"key":"4784_CR16","doi-asserted-by":"publisher","unstructured":"Abro MN, Khan ME, Ibrahim M et al (2023) Incidence of colorectal carcinoma in the remote area of Sindh, Pakistan. Adv Life Sci 9:539\u2013546. https:\/\/doi.org\/10.62940\/als.v9i4.1518","DOI":"10.62940\/als.v9i4.1518"},{"key":"4784_CR17","doi-asserted-by":"publisher","first-page":"45","DOI":"10.4103\/jrms.JRMS_531_17","volume":"23","author":"M Khodadoostan","year":"2018","unstructured":"Khodadoostan M, Shavakhi A, Padidarnia R et al (2018) Full colonoscopy in patients under 50 years old with lower gastrointestinal bleeding. Journal of Research in Medical Sciences 23:45. https:\/\/doi.org\/10.4103\/jrms.JRMS_531_17","journal-title":"Journal of Research in Medical Sciences"},{"key":"4784_CR18","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1007\/s00384-023-04524-4","volume":"38","author":"T Colles","year":"2023","unstructured":"Colles T, Ziegelmann PK, Damin DC (2023) The role of colonoscopy in young patients with rectal bleeding: a systematic review and meta-analysis. Int J Colorectal Dis 38:230. https:\/\/doi.org\/10.1007\/s00384-023-04524-4","journal-title":"Int J Colorectal Dis"},{"key":"4784_CR19","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1053\/j.gastro.2019.08.059","volume":"158","author":"LH Nguyen","year":"2020","unstructured":"Nguyen LH, Goel A, Chung DC (2020) Pathways of colorectal carcinogenesis. Gastroenterology 158:291\u2013302. https:\/\/doi.org\/10.1053\/j.gastro.2019.08.059","journal-title":"Gastroenterology"}],"container-title":["International Journal of Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00384-024-04784-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00384-024-04784-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00384-024-04784-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T04:30:21Z","timestamp":1736310621000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00384-024-04784-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,16]]},"references-count":19,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["4784"],"URL":"https:\/\/doi.org\/10.1007\/s00384-024-04784-8","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-5244844\/v1","asserted-by":"object"}]},"ISSN":["1432-1262"],"issn-type":[{"value":"1432-1262","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,16]]},"assertion":[{"value":"8 December 2024","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 December 2024","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"The authors declare no conflicts of interest.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"202"}}