title: Endoscopy for hematochezia in patients under 50 years of age.
abstract: The optimal strategy for evaluating rectal bleeding in young persons is unknown. This study examines the prevalence of adenomatous neoplasms identified at endoscopy for rectal bleeding. Retrospective cross-sectional analysis was made of patients under 50 years of age undergoing elective outpatient colonoscopy or flexible sigmoidoscopy for hematochezia. In all, 570 patients (309 F/261 M) met our inclusion criteria. The prevalence of neoplasms was 3.8% (95% CI 1.2-8.5%) among persons under 30, 2.8% (95% CI 0.9-6.3%) among persons age 30-39, and 10.9% (95% CI 7.4-15.4%) among persons age 40-49. The prevalence of neoplasms was higher in persons over age 40 (relative risk 3.43, 95% CI 1.70-6.94). Six of seven advanced neoplasms were identified in persons over age 40 (relative risk 7.4, 95% CI 0.89-60.7). In conclusion, the prevalence of colonic neoplasms in patients 40-50 years old with hematochezia is substantial. Among those persons younger than 40 years, the prevalence of colonic neoplasms is significantly lower.
authors.affiliation: Division of Gastroenterology, and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine Philadelphia 19104-6021, USA.
authors.forename: J D
authors.initials: JD
authors.lastname: Lewis
authors.forename: C E
authors.initials: CE
authors.lastname: Shih
authors.forename: D
authors.initials: D
authors.lastname: Blecker
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D003110:Colonic Neoplasms / Q000453:epidemiology*; D003113:Colonoscopy; D015897:Comorbidity; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012812:Sigmoidoscopy