MedicalResearch.com Interview with:
Mohammad Bilal, MD
University of Texas Medical Branch
MedicalResearch.com: What is the background for this study?
Response: Colorectal cancer (CRC) is the fourth most commonly diagnosed cancer among adults in the United States and the second leading cause of cancer related deaths. Recent studies have shown an increasing incidence of CRC in younger patients. This has led to increasing interests in identifying patient populations who might be at increased risk of developing CRC.
The U.S. Multi-Society Task Force of Colorectal Cancer (MSTF) recommends that CRC screening should begin at age 50 in average-risk persons. However, recently the American Cancer Society (ACS) have published recommendations to begin CRC screening at age 45 years in average risk patient population.
These recommendations were primarily based of modeling studies since there is little outcomes data in younger age groups in regards to prevention and detection of CRC. Despite these new recommendations from the ACS, there is limited direct evidence to support CRC screening at a younger age. In our study, we have evaluated the predictors of increased prevalence of adenomas in the 40 to 49-year-old individuals undergoing colonoscopy.
MedicalResearch.com: What are the main findings?
Response: The results of our study show that in addition to family history of colorectal carcinoma, the patient’s age, male gender, body mass index and chronic kidney disease are independent predictors of increased prevalence of adenomas in patients between 40 to 49 years of age. Our study suggests that rather than performing early colonoscopy on everyone, select group of individuals (obese males with chronic kidney disease) might benefit for early colonoscopic institution of CRC screening. Further large multi-center prospective studies are needed to validate these finding.
MedicalResearch.com: What should readers take away from your report?
Response: Male gender, increased body mass index (BMI) and chronic kidney disease are independent predictors of increased prevalence of adenomas in individuals between 40 to 49-years of age. Previously known factors such as family history of CRC and increased age are also associated with increased prevalence of adenomas in this age group. Our study suggests that rather than performing early colonoscopy on everyone at 45 years of age, it might be a more cost-effective and efficient strategy to institute early colonoscopic screening for colon cancer in a select group of individuals (obese males with CKD). Further large multi-center prospective studies are needed to validate these findings and model should be developed to identify vulnerable populations who might benefit from early colonoscopic screening for colon cancer.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Our study is a retrospective single center study and we have looked at diagnostic colonoscopies in patients who are 40 to 49-year-old so further prospective multi-center studies are needed to validate these findings. I personally believe that for patients between 45 to 50 years of age, early colonoscopic screening for colon cancer will lead to significant healthcare resource utilization. Hence, we need more studies to identify a “higher-risk” group that will benefit from early colonoscopic screening. However, we need more data to be able to safely say that.
MedicalResearch.com: Is there anything else you would like to add?
Response: Colon cancer is the 2nd leading cause of cancer related deaths in the United States. As the issue of starting colon cancer screening in patients < 50 years of age evolves, we must not forget and deviate that average risk patients at 50-years of age or those with family history of colon cancer should get screening done.
Does Everyone Need Early Colonoscopy? Select Group of Patients Might Benefit From Early Screening for Colorectal Cancer – An Update
Mohammad Bilal, MD1, Yamam I. Al-Saadi, MD2, Thanh-Truc Le, MD1, Shailendra Singh, MD3, Praveen Guturu, MD, FACG1
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