Most adults under 50 unlikely need colorectal screening

October 01, 2008

New study shows they have few pre-cancerous polyps

Young adults without a family history of bowel disease are unlikely to develop adenomas, the colorectal polyps most likely to lead to cancer, according to new research directed by scientists at the Johns Hopkins Kimmel Cancer Center. The finding supports current cancer screening guidelines recommending adults in general undergo screening colonoscopies starting at age 50.

The new study, published in the September issue of the journal Clinical Gastroenterology and Hepatology, also showed that white patients more often had adenomas on the left side of the colon, whereas African Americans had lesions more often on the right side. The take-home lesson, Giardiello says, is that screening and diagnostic evaluations of African Americans should include a colonoscopy rather than a sigmoidoscopy, because the latter evaluates only part of the colon.

The Hopkins study assessed the "natural history" and occurrence of colorectal polyps by reviewing records of 3,558 autopsies performed at The Johns Hopkins Hospital between 1985 and 2004 on patients aged 20 to 89. The review, called an "epidemiologic necropsy," categorized patients by sex, race and 10-year age groups, then compared the prevalence and location of adenomas between younger adults (ages 20 to 49) and older adults (ages 50 to 89).

The review identified a low but increasing prevalence ofcolorectal adenomas -- from 1.72 percent to 3.59 percent -- from the third to the fifth decade of life, with the presence of adenomas sharply increasing after age 50. Prevalence ranged from 10 to 12 percent from the sixth to ninth decade of life.

"Our study affirmed that the greatest increase in prevalence was in older adults, abruptly starting in the sixth decade," says Francis M. Giardiello, M.D., professor of medicine, oncology and pathology, who directed the research. The average number of adenomas spotted in most young adults was one. In older adults, the average number of adenomas ranged from 1.6 to 1.9.

Most polyps detected in colorectal screenings qualify as adenomas, but there are also lower-risk lesions called "hyperplastic" which are not thought to lead to cancer, the researchers note.

The researchers found that in young adults, adenomas were slightly more prevalent in men than in women and in whites than in blacks. In older adults, the prevalence of adenomas also was greater in men than in women, but greater in blacks than in whites.

In addition, the study found that in both younger and older adults, the overall prevalence of left-sided adenomas was higher than right-sided adenomas. Compared with younger adults, older adults had an increased prevalence of adenomas on both sides of the colorectum, but a relatively greater prevalence of right-sided adenomas.

Johns Hopkins Medical Institutions

---

---

	Canalicular adenoma.(Pathology Clinic): An article from: Ear, Nose and Throat Journal by Carla R. Penner (Author), Lester D.R. Thompson (Author) This digital document is an article from Ear, Nose and Throat Journal, published by Medquest Communications, LLC on March 1, 2005. The length of the article is 382 words. The page length shown above is based on a typical 300-word page. The article is delivered in HTML format and is available in your Amazon.com Digital Locker immediately after purchase. You can view it with any web browser. Citation Details Title: Canalicular adenoma.(Pathology Clinic) Author: Carla R. Penner Publication: Ear, Nose and Throat Journal (Refereed) Date: March 1, 2005 Publisher: Medquest Communications, LLC Volume: 84 Issue: 3 Page: 132(1) Distributed by Thompson...
	Molecular Pathology of Pituitary Adenomas (Elsevier Insights) by Cristiana Tanase (Author), Irina Ogrezeanu (Author), Corin Badiu (Author) The pituitary gland is an important one since it controls several of the other hormone glands such as the thyroid and adrenals. A pituitary adenoma is an abnormal growth, or tumor in this gland and they are the subject of very active clinical and pathological research. This book examines the latest developments in this field and discusses the most important molecules implicated in apoptosis, angiogenesis and signal transduction. A good understanding of these processes is needed in order to identify the best therapies. Facilitates the understanding of the processes involved and how they are translated into therapyIllustrations are used to explain the complex mechanisms involved
	Adenomas: Webster's Timeline History, 1880 - 2000 by Icon Group International (Author) Webster's bibliographic and event-based timelines are comprehensive in scope, covering virtually all topics, geographic locations and people. They do so from a linguistic point of view, and in the case of this book, the focus is on "Adenomas," including when used in literature (e.g. all authors that might have Adenomas in their name). As such, this book represents the largest compilation of timeline events associated with Adenomas when it is used in proper noun form. Webster's timelines cover bibliographic citations, patented inventions, as well as non-conventional and alternative meanings which capture ambiguities in usage. These furthermore cover all parts of speech (possessive, institutional usage, geographic usage) and contexts, including pop culture, the arts, social sciences...
	Adenomas: Webster's Timeline History, 2001 - 2007 by Icon Group International (Author) Webster's bibliographic and event-based timelines are comprehensive in scope, covering virtually all topics, geographic locations and people. They do so from a linguistic point of view, and in the case of this book, the focus is on "Adenomas," including when used in literature (e.g. all authors that might have Adenomas in their name). As such, this book represents the largest compilation of timeline events associated with Adenomas when it is used in proper noun form. Webster's timelines cover bibliographic citations, patented inventions, as well as non-conventional and alternative meanings which capture ambiguities in usage. These furthermore cover all parts of speech (possessive, institutional usage, geographic usage) and contexts, including pop culture, the arts, social sciences...
	Management of Pituitary Adenomas by Edward R. Laws (Author), etc. (Author)
	Advances in Pituitary Adenoma Research by European Workshop on Pituitary Adenomas 1987 (University of Zurich) (Author), A. M. Landolt (Author), A. M. Landolt (Contributor) This volume covers the proceedings of the 4th European Workshop, held in Zurich in September 1987 and discusses the newest research results in pituitary adenomas. Topics covered include the pathology, tumor biology, radiology, endocrinology, pharmacology and surgery of pituitary adenomas. A major part of this book is concerned with the new methods of medical treatment of prolactinomas, TSH-secreting adenomas and acromegaly, while several chapters compare the effectiveness of computed tomography and magnetic imaging in diagnosing pituitary adenomas. The techniques and results of inferior petrosal sinus blood sampling are also discussed in detail.
	Pituitary Adenoma by Kalmon D. Post (Editor)
	Pituitary Adenomas: New Trends in Basic and Clinical Research : Proceedings of the 5th European Workshop on Pituitary Adenomas, Venice, Italy, 17-20 (International Congress Series) by Italy) European Workshop on Pituitary Adenomas 1991 (Venice (Author), P. Beck-Peccoz (Author), G. Faglia (Author) Disciplines as diverse as neurosurgery and neuroendocrinology, radiology and pharmacology are directly interested in new trends in basic and clinical research in the area of pituitary tumors. A multidisciplinary forum thus provided the backdrop to the Fifth European Workshop on Pituitary Adenomas from which the manuscripts of invited lectures are collected in this volume. Dr Seymour Reichlin's main lecture presents the current view and most recent advances concerning the much debated pathogenesis of pituitary tumors. Other distinguished scientists cover topics concerning hypothalamic-pituitary regulatory mechanisms, biology, morphology, hormonal investigations, imaging and management of pituitary adenomas. Two Round Tables were devoted to the management of prolactinomas with new...
	Pituitary Adenomas by Klaus Von Werder (Author), Germany) European Workshop on Pituitary Adenomas 1996 (Berlin (Author), Rudolf Fahlbusch (Author), Rudolf Fahlbusch (Editor), K. Von Werder (Editor) Part of the INTERNATIONAL CONGRESS series presenting selected papers from the 6th European Workshop on Pituitary Adenomas in Berlin in 1996. Topics covered include: molecular biology, physiology, morphology, pharmacology, imaging techniques, neuroendocrinology and modern techniques in neurosurgery of pituitary tumors.
	Treatment of pituitary adenomas by PSG Pub. Co (Publisher)