ArticleDigestive diseases and sciences2025
A Score to Predict Advanced Colorectal Neoplasia in Adults Younger than Age 45.
Article in Digestive diseases and sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Association between concurrence of risk factors and intimate partner violence against women: evidence from Demographic and Health Surveys in 53 low- and middle-income countries.BMJ global health · 2026Article
- When the carcinogenic window opens before the screening window: the age-threshold blind spot in early-onset colorectal cancer.Frontiers in oncology · 2026Article
- Screening the Siblings: Advancing Colon Cancer Prevention by Identifying Advanced Polyps.Digestive diseases and sciences · 2025Article
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Authors and funding
7 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundEarly-onset colorectal cancer (CRC) requires identifying adults at heightened risk of advanced colorectal neoplasia (AN) who may warrant colonoscopy initiation < age 45 years.
aimsWe aim to develop and validate a model estimating the likelihood of AN in adults age < 45 years.
methodsWe performed a cross-sectional analysis of adults' ages 18-44 years who underwent a colonoscopy between 2011 and 2021 at a tertiary center. Subjects with AN constituted the case group while those with a normal colonoscopy or non-advanced neoplasia (NAN) formed the control group. We used backward elimination multivariable logistic regression methods to construct a model based on significant associations (p < 0.05) between risk factors and the presence of AN in a randomly selected training set and confirmed the associations in a validation set.
resultsAN was detected in 346 (3.7%) of the 9,446 participants included. The reduced logistic regression model based on the training set identified BMI (p = 0.0157), family history of CRC (first-degree relative < 60, p < 0.0001; other family history of CRC p = 0.0117), and tobacco use (current vs. never, p = 0.0015, former vs. never, p = 0.0009) as risk factors for AN. In the validation set, the model exhibited moderate discriminatory power (c-statistic 0.645). The prediction score estimated the likelihood of detecting AN in the complete dataset, from 1.8% for individuals scoring 1 to > 14% for individuals scoring ≥ 9.
conclusionWe developed and internally validated a simple score using clinical factors which successfully predicts the likelihood of AN in adults < 45 years undergoing colonoscopy. Once externally validated, the proposed risk score may be useful for individualized CRC screening strategies.
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