Comparative risk of high-risk neoplasia after polypectomy among individuals aged below 50 years versus 50 years and older
Background Limited evidence supports colonoscopy surveillance practices among individuals aged <50 years. - Objective To compare the risk of polyp recurrence and colorectal cancer (CRC) among young and old adults after polypectomy. - Design We prospectively examined the risk of metachronous high-...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article (Journal) |
| Language: | English |
| Published: |
2026
|
| In: |
Gut
Year: 2026, Volume: 75, Issue: 1, Pages: 72-80 |
| ISSN: | 1468-3288 |
| DOI: | 10.1136/gutjnl-2025-335275 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1136/gutjnl-2025-335275 Verlag, lizenzpflichtig, Volltext: https://gut.bmj.com/content/75/1/72 
|
| Author Notes: | Yufeng Chen, Jean Padilla Aponte, Kai Wang, Mengxi Du, Yujia Lu, Georgios Polychronidis, Mingyang Song |
| Summary: | Background Limited evidence supports colonoscopy surveillance practices among individuals aged <50 years. - Objective To compare the risk of polyp recurrence and colorectal cancer (CRC) among young and old adults after polypectomy. - Design We prospectively examined the risk of metachronous high-risk neoplasia, including high-risk adenoma, high-risk serrated polyp (SP) and CRC, according to index colonoscopy findings among individuals aged <50 years and ≥50 years who had received ≥1 follow-up colonoscopy in the Mass General Brigham Colonoscopy Cohort (2007-2023). We used a multivariable-adjusted Cox proportional hazards model to calculate HRs. - Results We identified 37 576 adults without polyps, 26 693 with adenomas and 15 425 with SPs (including 8303 with synchronous adenomas and SPs). Among these 10 977 (29.2%), 3385 (12.7%) and 2659 (17.2%) were diagnosed before age 50 years, respectively. The associations between index polyp findings and subsequent risk of high-risk neoplasia were stronger for age <50 years than ≥50 years; however, such differences disappeared (Pheterogeneity>0.05) once the analysis was restricted to index colonoscopy for screening purposes only. Among screened individuals, in both age groups, the association was particularly strong for individuals with index high-risk lesions and peaked at 3 years after polypectomy, with HRs (95% CI) of 4.60 (3.63 to 5.84) and 5.59 (3.89 to 8.03) for young adults with index high-risk adenoma and high-risk SPs, respectively. - Conclusion Patients undergoing polypectomy at a screening colonoscopy below age 50 years exhibited a similarly increased risk of metachronous neoplasia as those aged ≥50 years, suggesting that current surveillance guidelines developed in old adults may apply to young adults. |
|---|---|
| Item Description: | Online veröffentlicht: 24. August 2025 Gesehen am 04.02.2026 |
| Physical Description: | Online Resource |
| ISSN: | 1468-3288 |
| DOI: | 10.1136/gutjnl-2025-335275 |