{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T17:27:39Z","timestamp":1787851659758,"version":"build-2784847793"},"reference-count":44,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2023,11,16]],"date-time":"2023-11-16T00:00:00Z","timestamp":1700092800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Riga Stradins University"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Colorectal cancer (CRC) incidence is rapidly emerging among individuals &lt;50 years, termed as early-onset colorectal cancer (EOCRC). This study aimed to probe variations in tumorigenic pathology and relevant manifestations (polyp and adenoma incidence) between suspected cases of EOCRC and late-onset CRC (LOCRC; \u226550 years of age). Materials and Methods: Between September 2022 and February 2023, colonoscopy-based screening data from 1653 patients were included in this study. All eligible participants were divided into two groups, depending upon patient age, where Group 1 consisted of 1021 patients aged &lt;50 years while Group 2 consisted of 632 patients aged \u2265 50 years. Polyp samples were collected when identified peri-procedurally and characterized according to World Health Organization criteria. Results: Polyp detection rate was 42% for the &lt;50-year age group, while this was 76% for the \u226550-year age group. Additionally, the &lt;50-year age group predominated in hyperplastic polyp manifestation, particularly within the rectum and sigmoid colon. In addition, the \u226550-year age group had increased prevalence of serrated polyps and differing adenoma manifestations. Conclusions: This investigation served to highlight the importance of age stratification for CRC colonoscopy-based screening effectiveness, with particular reference to evaluations that are based on polyp localization within differing colon regions.<\/jats:p>","DOI":"10.3390\/medicina59112017","type":"journal-article","created":{"date-parts":[[2023,11,16]],"date-time":"2023-11-16T07:11:27Z","timestamp":1700118687000},"page":"2017","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Age-Based Comparative Analysis of Colorectal Cancer Colonoscopy Screening Findings"],"prefix":"10.3390","volume":"59","author":[{"given":"Ilona","family":"Vilkoite","sequence":"first","affiliation":[{"name":"Health Centre 4, LV-1012 Riga, Latvia"},{"name":"Digestive Diseases Center GASTRO, LV-1079 Riga, Latvia"},{"name":"Department of Doctoral Studies, Riga Stradins University, LV-1007 Riga, Latvia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivars","family":"Tolmanis","sequence":"additional","affiliation":[{"name":"Digestive Diseases Center GASTRO, LV-1079 Riga, Latvia"},{"name":"Department of Internal Diseases, Riga Stradins University, LV-1007 Riga, Latvia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hosams","family":"Abu Meri","sequence":"additional","affiliation":[{"name":"Health Centre 4, LV-1012 Riga, Latvia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9892-7765","authenticated-orcid":false,"given":"Inese","family":"Polaka","sequence":"additional","affiliation":[{"name":"Institute of Clinical and Preventive Medicine, University of Latvia, LV-1586 Riga, Latvia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7765-852X","authenticated-orcid":false,"given":"Linda","family":"Mezmale","sequence":"additional","affiliation":[{"name":"Institute of Clinical and Preventive Medicine, University of Latvia, LV-1586 Riga, Latvia"},{"name":"Riga East University Hospital, LV-1038 Riga, Latvia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2097-6698","authenticated-orcid":false,"given":"Aivars","family":"Lejnieks","sequence":"additional","affiliation":[{"name":"Department of Internal Diseases, Riga Stradins University, LV-1007 Riga, Latvia"},{"name":"Riga East University Hospital, LV-1038 Riga, Latvia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","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 A Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"101174","DOI":"10.1016\/j.tranon.2021.101174","article-title":"Global Colorectal Cancer Burden in 2020 and Projections to 2040","volume":"14","author":"Xi","year":"2021","journal-title":"Transl. Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1136\/gutjnl-2015-310912","article-title":"Global Patterns and Trends in Colorectal Cancer Incidence and Mortality","volume":"66","author":"Arnold","year":"2017","journal-title":"Gut"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2484","DOI":"10.1111\/ans.16060","article-title":"Increasing Rate of Colorectal Cancer in Younger Patients: A Review of Colonoscopy Findings in Patients under 50 at a Tertiary Institution","volume":"90","author":"Kim","year":"2020","journal-title":"ANZ J. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"3059","DOI":"10.1007\/s10620-019-05644-0","article-title":"Clinical and Genetic Characteristics of Colorectal Cancer in Persons under 50 Years of Age: A Review","volume":"64","author":"Strum","year":"2019","journal-title":"Dig. Dis. Sci."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1080\/00365521.2022.2088247","article-title":"Molecular and Cellular Pathways in Colorectal Cancer: Apoptosis, Autophagy and Inflammation as Key Players","volume":"57","author":"Yu","year":"2022","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1158\/1078-0432.CCR-19-2898","article-title":"Agrin in the Muscularis Mucosa Serves as a Biomarker Distinguishing Hyperplastic Polyps from Sessile Serrated Lesions","volume":"26","author":"Rickelt","year":"2020","journal-title":"Clin. Cancer Res."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Chen, T.-H., Hsu, H.-C., You, J.-F., Lai, C.-C., Tsou, Y.-K., Hsu, C.-L., Fann, C.S.J., Chien, R.-N., and Chang, M.-L. (2023). Extracellular Nicotinamide Phosphoribosyltransferase as a Surrogate Marker of Prominent Malignant Potential in Colonic Polyps: A 2-Year Prospective Study. Cancers, 15.","DOI":"10.3390\/cancers15061702"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1177\/030089160108700202","article-title":"The Clinicopathologic Characteristics of Colorectal Cancer in Patients under 50 Years of Age: Experience of an Oncology Center","volume":"87","author":"Yamac","year":"2001","journal-title":"Tumori"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1016\/S1470-2045(23)00156-0","article-title":"Utility of Polygenic Risk Scores in UK Cancer Screening: A Modelling Analysis","volume":"24","author":"Huntley","year":"2023","journal-title":"Lancet Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Zaborowski, A.M. (2023). REACCT Collaborative Colorectal Cancer in the Young: Research in Early Age Colorectal Cancer Trends (REACCT) Collaborative. Cancers, 15.","DOI":"10.3390\/cancers15112979"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1768","DOI":"10.1111\/jgh.16243","article-title":"Noninvasive Predictive Models Based on Lifestyle Analysis and Risk Factors for Early-Onset Colorectal Cancer","volume":"38","author":"Deng","year":"2023","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1016\/S0016-5085(97)70247-6","article-title":"What Is a Gold Standard for Colon Polyps?","volume":"112","author":"Waye","year":"1997","journal-title":"Gastroenterology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"5086","DOI":"10.3748\/wjg.v23.i28.5086","article-title":"Colorectal Cancer Screening: An Updated Review of the Available Options","volume":"23","author":"Issa","year":"2017","journal-title":"World J. Gastroenterol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1046\/j.1365-2168.2002.02120.x","article-title":"The Colorectal Adenoma-Carcinoma Sequence","volume":"89","author":"Leslie","year":"2002","journal-title":"Br. J. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1535","DOI":"10.1158\/1078-0432.CCR-10-2509","article-title":"Genomic and Epigenomic Integration Identifies a Prognostic Signature in Colon Cancer","volume":"17","author":"Yi","year":"2011","journal-title":"Clin. Cancer Res."},{"key":"ref_17","first-page":"509348","article-title":"Genetic and Epigenetic Events Generate Multiple Pathways in Colorectal Cancer Progression","volume":"2012","author":"Pancione","year":"2012","journal-title":"Patholog. Res. Int."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1734","DOI":"10.1056\/NEJMsr1714643","article-title":"International Agency for Research on Cancer Handbook Working Group the IARC Perspective on Colorectal Cancer Screening","volume":"378","author":"Vilahur","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1056\/NEJMoa1100370","article-title":"Colonoscopic Polypectomy and Long-Term Prevention of Colorectal-Cancer Deaths","volume":"366","author":"Zauber","year":"2012","journal-title":"N. Engl. J. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1298","DOI":"10.1056\/NEJMoa1309086","article-title":"Adenoma Detection Rate and Risk of Colorectal Cancer and Death","volume":"370","author":"Corley","year":"2014","journal-title":"N. Engl. J. Med."},{"key":"ref_21","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":"ref_22","doi-asserted-by":"crossref","unstructured":"Sifaki-Pistolla, D., Poimenaki, V., Fotopoulou, I., Saloustros, E., Mavroudis, D., Vamvakas, L., and Lionis, C. (2022). Significant Rise of Colorectal Cancer Incidence in Younger Adults and Strong Determinants: 30 Years Longitudinal Differences between under and over 50s. Cancers, 14.","DOI":"10.3390\/cancers14194799"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1001\/jamasurg.2014.1756","article-title":"Increasing Disparities in the Age-Related Incidences of Colon and Rectal Cancers in the United States, 1975\u20132010","volume":"150","author":"Bailey","year":"2015","journal-title":"JAMA Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1458","DOI":"10.3748\/wjg.v12.i9.1458","article-title":"Prognostic Factors of Young Patients with Colon Cancer after Surgery","volume":"12","author":"Liang","year":"2006","journal-title":"World J. Gastroenterol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1038\/s41572-023-00432-7","article-title":"Young-Onset Colorectal Cancer","volume":"9","author":"Spaander","year":"2023","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"(2003). Participants in the Paris Workshop the Paris Endoscopic Classification of Superficial Neoplastic Lesions: Esophagus, Stomach, and Colon: 30 November to 1 December 2002. Gastrointest. Endosc., 58, S3\u2013S43.","DOI":"10.1016\/S0016-5107(03)02159-X"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1053\/j.gastro.2012.05.006","article-title":"Validation of a Simple Classification System for Endoscopic Diagnosis of Small Colorectal Polyps Using Narrow-Band Imaging","volume":"143","author":"Hewett","year":"2012","journal-title":"Gastroenterology"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1016\/j.pathol.2020.10.010","article-title":"The 2019 World Health Organization Classification of Appendiceal, Colorectal and Anal Canal Tumours: An Update and Critical Assessment","volume":"53","author":"Ahadi","year":"2021","journal-title":"Pathology"},{"key":"ref_29","unstructured":"IBM (2023, June 07). SPSS Statistics-Overview. Available online: https:\/\/www.ibm.com\/products\/spss-statistics."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"326","DOI":"10.3322\/CA.57.6.326","article-title":"A Midpoint Assessment of the American Cancer Society Challenge Goal to Decrease Cancer Incidence by 25% between 1992 and 2015","volume":"57","author":"Sedjo","year":"2007","journal-title":"CA Cancer J. Clin."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1053\/gast.1997.v112.agast970594","article-title":"Colorectal Cancer Screening: Clinical Guidelines and Rationale","volume":"112","author":"Winawer","year":"1997","journal-title":"Gastroenterology"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1111\/j.1572-0241.2006.00673.x","article-title":"Quality Indicators for Colonoscopy","volume":"101","author":"Rex","year":"2006","journal-title":"Am. J. Gastroenterol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1053\/j.gastro.2008.02.032","article-title":"Colonoscopic Screening in Average-Risk Individuals Ages 40 to 49 vs 50 to 59 Years","volume":"134","author":"Rundle","year":"2008","journal-title":"Gastroenterology"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1280","DOI":"10.1053\/j.gastro.2023.06.033","article-title":"AGA Clinical Practice Update on Risk Stratification for Colorectal Cancer Screening and Post-Polypectomy Surveillance: Expert Review","volume":"165","author":"Issaka","year":"2023","journal-title":"Gastroenterology"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1503","DOI":"10.1007\/s10620-011-1565-6","article-title":"Detection of Colorectal Neoplasia by Colonoscopy in Average-Risk Patients Age 40\u201349 versus 50\u201359 Years","volume":"56","author":"Thoma","year":"2011","journal-title":"Dig. Dis. Sci."},{"key":"ref_36","first-page":"219","article-title":"Prevalence of Serrated Polyps and Association with Synchronous Advanced Neoplasia in Screening Colonoscopy","volume":"46","author":"Hazewinkel","year":"2014","journal-title":"Endoscopy"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"760","DOI":"10.7326\/0003-4819-113-10-760","article-title":"Risk for Colon Adenomas in Patients with Rectosigmoid Hyperplastic Polyps","volume":"113","author":"Provenzale","year":"1990","journal-title":"Ann. Intern. Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1328","DOI":"10.1007\/DCR.0b013e3181e10daa","article-title":"Impact of Lifestyle Factors on Colorectal Polyp Detection in the Screening Setting","volume":"53","author":"Hassan","year":"2010","journal-title":"Dis. Colon. Rectum"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1053\/j.gastro.2017.09.011","article-title":"Risk of Metachronous High-Risk Adenomas and Large Serrated Polyps in Individuals with Serrated Polyps on Index Colonoscopy: Data from the New Hampshire Colonoscopy Registry","volume":"154","author":"Anderson","year":"2018","journal-title":"Gastroenterology"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1053\/j.gastro.2020.09.015","article-title":"Interobserver Agreement among Pathologists in the Differentiation of Sessile Serrated from Hyperplastic Polyps","volume":"160","author":"Vennelaganti","year":"2021","journal-title":"Gastroenterology"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1097\/PAS.0b013e318093e40a","article-title":"Sessile Serrated Adenoma: Challenging Discrimination from Other Serrated Colonic Polyps","volume":"32","author":"Farris","year":"2008","journal-title":"Am. J. Surg. Pathol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1299","DOI":"10.1016\/S0140-6736(17)30396-3","article-title":"Long Term Effects of Once-Only Flexible Sigmoidoscopy Screening after 17 Years of Follow-Up: The UK Flexible Sigmoidoscopy Screening Randomised Controlled Trial","volume":"389","author":"Atkin","year":"2017","journal-title":"Lancet"},{"key":"ref_43","first-page":"389","article-title":"Colorectal Adenomas","volume":"375","author":"Strum","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1145","DOI":"10.1053\/j.gastro.2021.06.006","article-title":"Early-Age Onset Colorectal Neoplasia in Average-Risk Individuals Undergoing Screening Colonoscopy: A Systematic Review and Meta-Analysis","volume":"161","author":"Kolb","year":"2021","journal-title":"Gastroenterology"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/11\/2017\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:24:02Z","timestamp":1760131442000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/11\/2017"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,16]]},"references-count":44,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2023,11]]}},"alternative-id":["medicina59112017"],"URL":"https:\/\/doi.org\/10.3390\/medicina59112017","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,16]]}}}