title: Prevalence of adenomas and advanced adenomas in patients in the 40- to 49-year age group undergoing screening colonoscopy because of a family history of adenoma/polyp in a first-degree relative.
abstract: BACKGROUND
  Per current guidelines, patients with a first-degree relative (FDR) with adenomas should get screened at age 40. Data on the prevalence of adenomas and advanced adenomas (AAs) in these patients are lacking.
  
  
  OBJECTIVE
  To examine the prevalence of adenomas and AAs in 40- to 49-year-old individuals undergoing screening colonoscopy because of a family history (FH) of polyps and to compare these data with those of a control population of similar age.
  
  
  METHODS
  Retrospective cross-sectional study.
  
  
  METHODS
  Tertiary care academic medical center and Veterans Affairs medical center.
  
  
  METHODS
  Study subjects included all 40- to 49-year-old asymptomatic individuals undergoing initial screening colonoscopy at our institution from January 1, 2006, to June 1, 2009, because of an FDR with polyps. The control population consisted of all 40- to 49-year-old individuals who underwent their first colonoscopy during the same period because of abdominal pain, diarrhea, or constipation without an FH of polyps or colorectal cancer.
  
  
  METHODS
  Colonoscopy.
  
  
  METHODS
  The prevalence of adenomas of any size, AAs, and risk factors associated with adenomas.
  
  
  RESULTS
  The prevalence of adenomas was greater in the FH of polyps group (n = 176) compared with the control sample (n = 178) (26.7% vs 13.5%; P = .002) but was not statistically greater for AAs (5.7% vs 3.4%; P = .3). After adjusting for confounders, FH of a polyp was associated with an increased prevalence of adenomas (odds ratio 2.8 [95% CI, 1.4-5.5]).
  
  
  CONCLUSIONS
  Limited data on polyp histology in FDRs and limited sample size.
  
  
  CONCLUSIONS
  Among 40- to 49-year-old patients undergoing screening colonoscopy because of an FDR with polyps, the prevalence of adenomas was greater than in a control population. Prospective research is needed to quantify the prevalence of AAs in this group and to determine whether these individuals should undergo screening colonoscopy at age 40.
authors.affiliation: Division of Gastroenterology, University of Michigan School of Medicine, Ann Arbor, Michigan, USA.
authors.forename: Akshay
authors.initials: A
authors.lastname: Gupta
authors.forename: Jewel
authors.initials: J
authors.lastname: Samadder
authors.forename: Eric
authors.initials: E
authors.lastname: Elliott
authors.forename: Saurabh
authors.initials: S
authors.lastname: Sethi
authors.forename: Philip
authors.initials: P
authors.lastname: Schoenfeld
mesh_terms: D000236:Adenoma / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology*; D000328:Adult; D003110:Colonic Neoplasms / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology*; D003113:Colonoscopy; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors