{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T16:46:01Z","timestamp":1790959561085,"version":"4.1.0"},"reference-count":85,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,11,29]],"date-time":"2025-11-29T00:00:00Z","timestamp":1764374400000},"content-version":"vor","delay-in-days":30,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008247","name":"University of Otago","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008247","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>An increase in early-onset colorectal cancer has been observed globally, despite a decline in colorectal cancer incidence rates in many Western countries. Screening strategies for younger individuals are particularly challenging, as there are limited data on polyps in young individuals to guide clinicians. This study aimed to systematically review the current evidence surrounding polyp distribution in different age groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A literature search was performed in PubMed, Scopus, MEDLINE, Embase (OVID), Web of Science, and Cochrane Review databases using the keywords \u2018age\u2019 and \u2018polyp\u2019, and Medical Subject Heading terms \u2018age of onset\u2019, \u2018age factors\u2019, \u2018age distribution\u2019, and \u2018age groups\u2019, with no restrictions on publication year. Articles published in English that described the distribution of polyps (adenomatous, advanced adenomatous polyps, and sessile serrated lesions) or individuals with polyps according to different age groups were considered for inclusion. Younger patients were defined as those aged &amp;lt; 50 years. The outcomes of interest were the number of patients with polyps in the left and\/or right colon, or the number of polyps per side of the colorectum in different age groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From 12 470 articles, 24 met the eligibility criteria for the systematic review, and 12 were suitable for meta-analysis. Among younger people, 46.5% had right-sided and 75.9% had left-sided polyps. In comparison, 70.8% of the older group had right-sided and 61.9% had left-sided polyps. Meta-analyses of studies showed a greater proportion of younger people than older people with at least one left-sided polyp (mean difference 0.06, 95% confidence interval (c.i.) 0.03 to 0.09; P &amp;lt; 0.001). There was also a greater proportion of left-sided polyps in younger people (odds ratio 0.77, 95% c.i. 0.59 to 1.01; P &amp;lt; 0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients aged &amp;lt; 50 years have a greater tendency towards having polyps in the left colon, compared with people \u2265 50 years of age, similar to the distribution of early-onset colorectal cancer. This has implications for the methodology of screening and investigation of symptoms in those aged &amp;lt; 50 years.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjsopen\/zraf132","type":"journal-article","created":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T11:47:35Z","timestamp":1758196055000},"source":"Crossref","is-referenced-by-count":3,"title":["Colorectal polyp distribution in relation to age: meta-analysis"],"prefix":"10.1093","volume":"9","author":[{"given":"Sai Tim","family":"Yam","sequence":"first","affiliation":[{"name":"Department of Surgery and Critical Care, University of Otago , Christchurch ,","place":["New Zealand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jared","family":"McLauchlan","sequence":"additional","affiliation":[{"name":"Department of Surgery and Critical Care, University of Otago , Christchurch ,","place":["New Zealand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"McCombie","sequence":"additional","affiliation":[{"name":"Department of Surgery, Te Whatu Ora Waitaha Canterbury , Christchurch ,","place":["New Zealand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Purcell","sequence":"additional","affiliation":[{"name":"Department of Surgery and Critical Care, University of Otago , Christchurch ,","place":["New Zealand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Pearson","sequence":"additional","affiliation":[{"name":"Department of Surgery and Critical Care, University of Otago , Christchurch ,","place":["New Zealand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Frizelle","sequence":"additional","affiliation":[{"name":"Department of Surgery and Critical Care, University of Otago , Christchurch ,","place":["New Zealand"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,11,29]]},"reference":[{"key":"2025112901032355900_zraf132-B1","first-page":"209","article-title":"Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J Clin"},{"key":"2025112901032355900_zraf132-B2","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1136\/jim-2016-000229","article-title":"Colorectal cancer is a leading cause of cancer incidence and mortality among adults younger than 50 years in the USA: a SEER-based analysis with comparison to other young-onset cancers","volume":"65","author":"Bhandari","year":"2017","journal-title":"J Investig Med"},{"key":"2025112901032355900_zraf132-B3","doi-asserted-by":"crossref","first-page":"1820","DOI":"10.1136\/gutjnl-2018-317592","article-title":"Increasing incidence of colorectal cancer in young adults in Europe over the last 25 years","volume":"68","author":"Vuik","year":"2019","journal-title":"Gut"},{"key":"2025112901032355900_zraf132-B4","doi-asserted-by":"crossref","first-page":"1547","DOI":"10.1056\/NEJMra2200869","article-title":"Increasing incidence of early-onset colorectal cancer","volume":"386","author":"Sinicrope","year":"2022","journal-title":"N Engl J Med"},{"key":"2025112901032355900_zraf132-B5","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1002\/bjs.11486","article-title":"Demographic trends in the incidence of young-onset colorectal cancer: a population-based study","volume":"107","author":"Chambers","year":"2020","journal-title":"Br J Surg"},{"key":"2025112901032355900_zraf132-B6","first-page":"177","article-title":"Colorectal cancer statistics, 2017","volume":"67","author":"Siegel","year":"2017","journal-title":"CA Cancer J Clin"},{"key":"2025112901032355900_zraf132-B7","first-page":"233","article-title":"Colorectal cancer statistics, 2023","volume":"73","author":"Siegel","year":"2023","journal-title":"CA Cancer J Clin"},{"key":"2025112901032355900_zraf132-B8","doi-asserted-by":"crossref","first-page":"4354","DOI":"10.1002\/cncr.25432","article-title":"Increasing incidence of rectal cancer in patients aged younger than 40 years: an analysis of the surveillance, epidemiology, and end results database","volume":"116","author":"Meyer","year":"2010","journal-title":"Cancer"},{"key":"2025112901032355900_zraf132-B9","doi-asserted-by":"crossref","first-page":"2002","DOI":"10.1002\/cncr.31994","article-title":"Clinical and molecular characterization of early-onset colorectal cancer","volume":"125","author":"Willauer","year":"2019","journal-title":"Cancer"},{"key":"2025112901032355900_zraf132-B10","first-page":"12 420","volume-title":"Early-onset colorectal cancer: a sporadic or inherited disease? World J Gastroenterol","author":"Stigliano","year":"2014"},{"key":"2025112901032355900_zraf132-B11","first-page":"109","volume-title":"Early-onset colorectal cancer in young individuals. Mol Oncol","author":"Mauri","year":"2019"},{"key":"2025112901032355900_zraf132-B12","first-page":"521","volume-title":"Early onset sporadic colorectal cancer: worrisome trends and oncogenic features. Dig Liver Dis","author":"Cavestro","year":"2018"},{"key":"2025112901032355900_zraf132-B13","doi-asserted-by":"crossref","first-page":"3602","DOI":"10.1007\/s10620-019-05690-8","article-title":"Epidemiology of colorectal cancer in average risk adults 20\u201339 years of age: a population-based national study","volume":"64","author":"Glover","year":"2019","journal-title":"Dig Dis Sci"},{"key":"2025112901032355900_zraf132-B14","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.42340","article-title":"Early-onset\/young-onset colorectal carcinoma: a comparative analysis of morphological features and biomarker profile","author":"Hashmi","year":"2023","journal-title":"Cureus"},{"key":"2025112901032355900_zraf132-B15","doi-asserted-by":"crossref","first-page":"e8241","DOI":"10.1097\/MD.0000000000008241","article-title":"Comparison of oncological outcomes of right-sided colon cancer versus left-sided colon cancer after curative resection","volume":"96","author":"Lim","year":"2017","journal-title":"Medicine (Baltimore)"},{"key":"2025112901032355900_zraf132-B16","doi-asserted-by":"crossref","first-page":"1493","DOI":"10.1111\/j.1463-1318.2012.03048.x","article-title":"The relationship between tumour site, clinicopathological characteristics and cancer-specific survival in patients undergoing surgery for colorectal cancer","volume":"14","author":"Powell","year":"2012","journal-title":"Colorectal Dis"},{"key":"2025112901032355900_zraf132-B17","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1111\/j.1463-1318.2010.02356.x","article-title":"Outcome of right- and left-sided colonic and rectal cancer following surgical resection","volume":"13","author":"Suttie","year":"2011","journal-title":"Colorectal Dis"},{"key":"2025112901032355900_zraf132-B18","first-page":"65","article-title":"Distribution of cancer and adenomatous polyps in the colorectum: study in an Iranian population","volume":"7","author":"Bafandeh","year":"2006","journal-title":"Asian Pac J Cancer Prev"},{"key":"2025112901032355900_zraf132-B19","first-page":"222","article-title":"The Anatomical Distribution of Colorectal Polyps at Colonoscopy","volume-title":"J Clin Gastroenterol","author":"Patel","year":"2001"},{"key":"2025112901032355900_zraf132-B20","doi-asserted-by":"crossref","first-page":"154","DOI":"10.4103\/1319-3767.132986","article-title":"Prevalence and characteristics of colonic polyps and adenomas in 2654 colonoscopies in Saudi Arabia","volume":"20","author":"Almadi","year":"2014","journal-title":"Saudi J Gastroenterol"},{"key":"2025112901032355900_zraf132-B21","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.1007\/s00384-022-04191-x","article-title":"Disparate age and sex distribution of sessile serrated lesions and conventional adenomas in an outpatient colonoscopy population\u2013implications for colorectal cancer screening?","volume":"37","author":"Lall","year":"2022","journal-title":"Int J Colorectal Dis"},{"key":"2025112901032355900_zraf132-B22","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1046\/j.1365-2168.2002.02120.x","article-title":"The colorectal adenoma\u2013carcinoma sequence","volume":"89","author":"Leslie","year":"2002","journal-title":"Br J Surg"},{"key":"2025112901032355900_zraf132-B23","first-page":"1017","volume-title":"The molecular hallmarks of the serrated pathway in colorectal cancer. Cancers (Basel)","author":"De Palma","year":"2019"},{"key":"2025112901032355900_zraf132-B24","doi-asserted-by":"crossref","first-page":"4461","DOI":"10.3390\/ijms23084461","article-title":"Serrated colorectal lesions: an up-to-date review from histological pattern to molecular pathogenesis","volume":"23","author":"Mezzapesa","year":"2022","journal-title":"Int J Mol Sci"},{"key":"2025112901032355900_zraf132-B25","first-page":"250","article-title":"Colorectal cancer screening for average-risk adults: 2018 guideline update from the American Cancer Society","volume":"68","author":"Wolf","year":"2018","journal-title":"CA Cancer J Clin"},{"key":"2025112901032355900_zraf132-B26"},{"key":"2025112901032355900_zraf132-B27","author":"Australian Government Department of Health and Aged Care"},{"key":"2025112901032355900_zraf132-B28","author":"Mary Afemata"},{"key":"2025112901032355900_zraf132-B29","author":"Australian Government Department of Health D and A"},{"key":"2025112901032355900_zraf132-B30","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"2025112901032355900_zraf132-B31","first-page":"1","article-title":"Conducting meta-analyses in R with the metafor package","volume":"36","author":"Viechtbauer","year":"2010","journal-title":"JSS J Stat Softw"},{"key":"2025112901032355900_zraf132-B32","article-title":"Assembling Data for a Meta-Analysis of (Log) Odds Ratios","author":"Viechtbauer"},{"key":"2025112901032355900_zraf132-B33","author":"Viechtbauer"},{"key":"2025112901032355900_zraf132-B34","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1097\/DCR.0000000000002069","article-title":"Understanding the burden of colorectal adenomas in patients younger than 50 years: a large single-center retrospective cohort study","volume":"65","author":"Pang","year":"2022","journal-title":"Dis Colon Rectum"},{"key":"2025112901032355900_zraf132-B35","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1002\/1097-0142(19820215)49:4<819::AID-CNCR2820490435>3.0.CO;2-D","article-title":"The prevalence of polyps of the large intestine in Oslo: an autopsy study","volume":"49","author":"Vatn","year":"1982","journal-title":"Cancer"},{"key":"2025112901032355900_zraf132-B36","doi-asserted-by":"crossref","first-page":"428","DOI":"10.5694\/j.1326-5377.2000.tb124039.x","article-title":"Distribution of colorectal adenomas: implications for bowel cancer screening","volume":"172","author":"Nicholson","year":"2000","journal-title":"Med J Aust"},{"key":"2025112901032355900_zraf132-B37","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1111\/j.1572-0241.2001.03638.x","article-title":"Gender differences in colorectal polyps and tumors","volume":"96","author":"McCashland","year":"2001","journal-title":"Am J Gastroenterol"},{"key":"2025112901032355900_zraf132-B38","doi-asserted-by":"crossref","first-page":"1781","DOI":"10.1056\/NEJM200206063462304","article-title":"Results of screening colonoscopy among persons 40 to 49 years of age","volume":"346","author":"Imperiale","year":"2002","journal-title":"N Engl J Med"},{"key":"2025112901032355900_zraf132-B39","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1111\/jgh.13482","article-title":"Clinicopathological characteristics of serrated polyps as precursors to colorectal cancer: current status and management","volume":"32","author":"Okamoto","year":"2017","journal-title":"J Gastroenterol Hepatol"},{"key":"2025112901032355900_zraf132-B40","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1016\/j.gie.2005.09.014","article-title":"Right-side shift of colorectal adenomas with aging","volume":"63","author":"Yamaji","year":"2006","journal-title":"Gastrointest Endosc"},{"key":"2025112901032355900_zraf132-B41","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1111\/j.1572-0241.2006.00430.x","article-title":"The prevalence rate and anatomic location of colorectal adenoma and cancer detected by colonoscopy in average-risk individuals aged 40\u201380 years","volume":"101","author":"Strul","year":"2006","journal-title":"Am J Gastroenterol"},{"key":"2025112901032355900_zraf132-B42","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1016\/j.cgh.2008.03.022","article-title":"Occurrence of colorectal adenomas in younger adults: an epidemiologic necropsy study","volume":"6","author":"Pendergrass","year":"2008","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2025112901032355900_zraf132-B43","doi-asserted-by":"crossref","first-page":"1417","DOI":"10.1001\/jama.300.12.1417","article-title":"Prevalence of colon polyps detected by colonoscopy screening in asymptomatic black and white patients","volume":"300","author":"Lieberman","year":"2008","journal-title":"JAMA"},{"key":"2025112901032355900_zraf132-B44","doi-asserted-by":"crossref","first-page":"1668","DOI":"10.1111\/j.1440-1746.2010.06414.x","article-title":"Distribution trends of colorectal adenoma and cancer: a colonoscopy database analysis of 11 025 Chinese patients","volume":"25","author":"Bai","year":"2010","journal-title":"J Gastroenterol Hepatol"},{"key":"2025112901032355900_zraf132-B45","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1016\/j.clinre.2011.12.016","article-title":"Prevalence of proximal colon serrated polyps in a population at average risk undergoing screening colonoscopy: a multicenter study","volume":"36","author":"Min","year":"2012","journal-title":"Clin Res Hepatol Gastroenterol"},{"key":"2025112901032355900_zraf132-B46","doi-asserted-by":"crossref","first-page":"9773","DOI":"10.7314\/APJCP.2014.15.22.9773","article-title":"Prevalence of colorectal polyps in a group of subjects at average-risk of colorectal cancer undergoing colonoscopic screening in Tehran, Iran between 2008 and 2013","volume":"15","author":"Sohrabi","year":"2014","journal-title":"Asian Pac J Cancer Prev"},{"key":"2025112901032355900_zraf132-B47","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1097\/CEJ.0000000000000097","article-title":"Prevalence of colorectal adenoma in an average-risk population aged 40\u201350 versus 50\u201360 years","volume":"24","author":"Hemmasi","year":"2015","journal-title":"Eur J Cancer Prev"},{"key":"2025112901032355900_zraf132-B48","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1177\/2050640615610266","article-title":"Distribution, size and shape of colorectal adenomas as determined by a colonoscopist with a high lesion detection rate: influence of age, sex and colonoscopy indication","volume":"4","author":"Klein","year":"2016","journal-title":"United European Gastroenterol J"},{"key":"2025112901032355900_zraf132-B49","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12876-016-0497-1","article-title":"Colonic polyp histopathology and location in a community-based sample of older adults","volume":"16","author":"Laird-Fick","year":"2016","journal-title":"BMC Gastroenterol"},{"key":"2025112901032355900_zraf132-B50","doi-asserted-by":"crossref","first-page":"1637","DOI":"10.1007\/s10620-016-4381-1","article-title":"Adenoma prevalence and distribution among US Latino subgroups undergoing screening colonoscopy","volume":"62","author":"Chablani","year":"2017","journal-title":"Dig Dis Sci"},{"key":"2025112901032355900_zraf132-B51","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/00365521.2016.1218929","article-title":"The association between location, age and advanced colorectal adenoma characteristics: a propensity-matched analysis","volume":"52","author":"Pommergaard","year":"2017","journal-title":"Scand J Gastroenterol"},{"key":"2025112901032355900_zraf132-B52","doi-asserted-by":"crossref","first-page":"81","DOI":"10.3892\/mco.2017.1284","article-title":"Clinical, endoscopic and pathological characteristics of colorectal polyps in elderly patients: single-center experience","volume":"7","author":"Zhou","year":"2017","journal-title":"Mol Clin Oncol"},{"key":"2025112901032355900_zraf132-B53","first-page":"47","article-title":"Epidemiological aspects of endoscopic resections of colorectal polyps in patients at an endoscopy training center in the Santos region, Brasil","volume":"37","author":"Filho","year":"2017","journal-title":"Rev Gastroenterol Peru"},{"key":"2025112901032355900_zraf132-B54","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1097\/DCR.0000000000001062","article-title":"Left-sided dominance of early-onset colorectal cancers: a rationale for screening flexible sigmoidoscopy in the young","volume":"61","author":"Segev","year":"2018","journal-title":"Dis Colon Rectum"},{"key":"2025112901032355900_zraf132-B55","doi-asserted-by":"crossref","first-page":"2201","DOI":"10.1007\/s00384-019-03445-5","article-title":"Location of colorectal adenomas and serrated polyps in patients under age 50","volume":"34","author":"Chen","year":"2019","journal-title":"Int J Colorectal Dis"},{"key":"2025112901032355900_zraf132-B56","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1016\/j.jss.2019.07.004","article-title":"High prevalence of adenomatous polyps in Alaska native people aged 40\u201349 years","volume":"243","author":"Conway","year":"2019","journal-title":"J Surg Res"},{"key":"2025112901032355900_zraf132-B57","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1002\/ijc.34306","article-title":"Epidemiology of overall and early-onset serrated polyps versus conventional adenomas in a colonoscopy screening cohort","volume":"152","author":"Vithayathil","year":"2023","journal-title":"Int J Cancer"},{"key":"2025112901032355900_zraf132-B58","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1067\/mge.2002.122335","article-title":"Relationship between age and site of colorectal cancer based on colonoscopy findings","volume":"55","author":"Okamoto","year":"2002","journal-title":"Gastrointest Endosc"},{"key":"2025112901032355900_zraf132-B59","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1007\/s00384-020-03504-2","article-title":"The location of premalignant colorectal polyps under age 50: a further rationale for screening sigmoidoscopy","volume":"35","author":"Segev","year":"2020","journal-title":"Int J Colorectal Dis"},{"key":"2025112901032355900_zraf132-B60","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1590\/S0102-67202014000200006","article-title":"Influence of patient age and colorectal polyp size on histopathology findings","volume":"27","author":"Silva","year":"2014","journal-title":"Arq Bras Cir Dig"},{"key":"2025112901032355900_zraf132-B61","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/j.cgh.2012.09.010","article-title":"Variation of adenoma prevalence by age, sex, race, and colon location in a large population: implications for screening and quality programs","volume":"11","author":"Corley","year":"2013","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2025112901032355900_zraf132-B62","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.3109\/00365528109181023","article-title":"Distribution of polyps in the large bowel in relation to age: a colonoscopic study","volume":"16","author":"Granqvist","year":"1981","journal-title":"Scand J Gastroenterol"},{"key":"2025112901032355900_zraf132-B63","first-page":"177","volume-title":"Cause, epidemiology, and histology of polyps and pathways to colorectal cancer. Gastrointest Endosc Clin N Am","author":"Sullivan","year":"2022"},{"key":"2025112901032355900_zraf132-B64","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.1093\/annonc\/mdy033","article-title":"European cancer mortality predictions for the year 2018 with focus on colorectal cancer","volume":"29","author":"Malvezzi","year":"2018","journal-title":"Ann Oncol"},{"key":"2025112901032355900_zraf132-B65","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1016\/j.cgh.2016.08.037","article-title":"Decrease in incidence of colorectal cancer among individuals 50 years or older after recommendations for population-based screening","volume":"15","author":"Murphy","year":"2017","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2025112901032355900_zraf132-B66","doi-asserted-by":"crossref","first-page":"e2324038","DOI":"10.1001\/jamanetworkopen.2023.24038","article-title":"Synchronous neoplasia rates at colonoscopic diagnosis of early-onset vs average-onset colorectal cancer","volume":"6","author":"Emiloju","year":"2023","journal-title":"JAMA Netw Open"},{"key":"2025112901032355900_zraf132-B67","doi-asserted-by":"crossref","first-page":"966","DOI":"10.1016\/j.cgh.2010.06.030","article-title":"Low frequency of Lynch syndrome among young patients with non-familial colorectal cancer","volume":"8","author":"Goel","year":"2010","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2025112901032355900_zraf132-B68","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1001\/jamaoncol.2016.5194","article-title":"Prevalence and spectrum of germline cancer susceptibility gene mutations among patients with early-onset colorectal cancer","volume":"3","author":"Pearlman","year":"2017","journal-title":"JAMA Oncol"},{"key":"2025112901032355900_zraf132-B69","doi-asserted-by":"crossref","first-page":"3544","DOI":"10.1200\/JCO.2015.61.4503","article-title":"High prevalence of hereditary cancer syndromes in adolescents and young adults with colorectal cancer","volume":"33","author":"Mork","year":"2015","journal-title":"J Clin Oncol"},{"key":"2025112901032355900_zraf132-B70","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1007\/s00268-004-7306-7","article-title":"Do young colon cancer patients have worse outcomes?","volume":"28","author":"O\u2019Connell","year":"2004","journal-title":"World J Surg"},{"key":"2025112901032355900_zraf132-B71","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1038\/modpathol.2012.61","article-title":"Clinicopathologic and molecular features of sporadic early-onset colorectal adenocarcinoma: an adenocarcinoma with frequent signet ring cell differentiation, rectal and sigmoid involvement, and adverse morphologic features","volume":"25","author":"Chang","year":"2012","journal-title":"Mod Pathol"},{"key":"2025112901032355900_zraf132-B72","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1002\/bjs.11333","article-title":"Population-based analysis of outcomes with early-age colorectal cancer","volume":"107","author":"Saraste","year":"2020","journal-title":"Br J Surg"},{"key":"2025112901032355900_zraf132-B73","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1001\/jamasurg.2014.3572","article-title":"Overtreatment of young adults with colon cancer: more intense treatments with unmatched survival gains","volume":"150","author":"Kneuertz","year":"2015","journal-title":"JAMA Surg"},{"key":"2025112901032355900_zraf132-B74","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1007\/s11864-017-0463-3","article-title":"The rising incidence of younger patients with colorectal cancer: questions about screening, biology, and treatment","volume":"18","author":"Connell","year":"2017","journal-title":"Curr Treat Options Oncol"},{"key":"2025112901032355900_zraf132-B75","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1016\/j.amjsurg.2015.08.031","article-title":"Rectal cancer in patients under the age of 50 years: the delayed diagnosis","volume":"211","author":"Scott","year":"2016","journal-title":"Am J Surg"},{"key":"2025112901032355900_zraf132-B76","doi-asserted-by":"crossref","first-page":"1900","DOI":"10.3390\/cancers11121900","article-title":"Association of polyps with early-onset colorectal cancer and throughout surveillance: novel clinical and molecular implications","volume":"11","author":"Garc\u00eda","year":"2019","journal-title":"Cancers (Basel)"},{"key":"2025112901032355900_zraf132-B77","doi-asserted-by":"crossref","first-page":"3722","DOI":"10.1038\/s41467-019-11530-0","article-title":"Comprehensive characterization of RAS mutations in colon and rectal cancers in old and young patients","volume":"10","author":"Serebriiskii","year":"2019","journal-title":"Nat Commun"},{"key":"2025112901032355900_zraf132-B78","doi-asserted-by":"crossref","first-page":"5852","DOI":"10.1158\/1078-0432.CCR-19-0899","article-title":"Comprehensive genomic landscapes in early and later onset colorectal cancer","volume":"25","author":"Lieu","year":"2019","journal-title":"Clin Cancer Res"},{"key":"2025112901032355900_zraf132-B79","first-page":"1229","volume-title":"Risk factors for early-onset colorectal cancer: a systematic review and meta-analysis. Clin Gastroenterol Hepatol","author":"O\u2019Sullivan","year":"2022"},{"key":"2025112901032355900_zraf132-B80","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1002\/ijc.31100","article-title":"Body fatness at an early age and risk of colorectal cancer","volume":"142","author":"Hidayat","year":"2018","journal-title":"Int J Cancer"},{"key":"2025112901032355900_zraf132-B81","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1053\/j.gastro.2016.09.003","article-title":"Lifestyle risk factors for serrated colorectal polyps: a systematic review and meta-analysis","volume":"152","author":"Bailie","year":"2017","journal-title":"Gastroenterology"},{"key":"2025112901032355900_zraf132-B82","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1146\/annurev-micro-102215-095513","article-title":"Gut microbiota, inflammation, and colorectal cancer","volume":"70","author":"Brennan","year":"2016","journal-title":"Annu Rev Microbiol"},{"key":"2025112901032355900_zraf132-B83","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1038\/s41575-019-0209-8","article-title":"Gut microbiota in colorectal cancer: mechanisms of action and clinical applications","volume":"16","author":"Wong","year":"2019","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"2025112901032355900_zraf132-B84","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1053\/j.gastro.2020.03.025","article-title":"Prevalence and clinical features of sessile serrated polyps: a systematic review","volume":"159","author":"Meester","year":"2020","journal-title":"Gastroenterology"},{"key":"2025112901032355900_zraf132-B85","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1186\/1471-230X-11-101","article-title":"Determinants of polyp size in patients undergoing screening colonoscopy","volume":"11","author":"Lowenfels","year":"2011","journal-title":"BMC Gastroenterol"}],"container-title":["BJS Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/bjsopen\/article-pdf\/9\/6\/zraf132\/65637883\/zraf132.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjsopen\/article-pdf\/9\/6\/zraf132\/65637883\/zraf132.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,29]],"date-time":"2025-11-29T06:03:37Z","timestamp":1764396217000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjsopen\/article\/doi\/10.1093\/bjsopen\/zraf132\/8355846"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,30]]},"references-count":85,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,10,30]]}},"URL":"https:\/\/doi.org\/10.1093\/bjsopen\/zraf132","relation":{},"ISSN":["2474-9842"],"issn-type":[{"value":"2474-9842","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,12]]},"published":{"date-parts":[[2025,10,30]]},"article-number":"zraf132"}}