New score predicts colorectal neoplasia in young adults

Researchers have created a new scoring tool that can help predict advanced colorectal neoplasia in young adults under 45. This is important because early-onset colorectal cancer is rising, but this age group is not typically recommended for screening. The scoring system uses several clinical factors. It takes into account factors like age, sex, race, family history of colorectal cancer, lifestyle choices like smoking and alcohol use, and health conditions like obesity and diabetes. This information can help identify young adults who might need earlier screening. Dr. Carole Macaron, the study's lead author, stated that primary care providers can easily calculate this score in their offices. Patients with a higher score would be referred for colorectal cancer screening. The study analyzed data from nearly 9,500 patients aged 18 to 44 who underwent colonoscopy. Of these, 346 were found to have advanced neoplasia, defined by specific characteristics of the polyps. The researchers identified key risk factors, including body mass index, tobacco use, and family history of cancer, to create the risk score. The score can estimate the risk of advanced neoplasia, with scores ranging from 1.8% risk at the lowest to 22.2% at the highest. For example, a 32-year-old overweight person with a history of tobacco use and a family member diagnosed with colorectal cancer before 60 years old would have a 20.3% risk. The researchers found that the scoring tool showed moderate effectiveness in distinguishing between high and low-risk individuals. However, there is a need for further validation of the score in everyday clinical settings. Experts believe that if the score is confirmed through real-world use, it could help in screening young adults who are at risk for colorectal cancer. The researchers hope to improve the tool and make it more accessible in medical records or online resources. However, the study has its limitations, including its focus on a specific population, which may not reflect the broader community. Both Dr. Macaron and Dr. Steven H. Itzkowitz emphasized the need for accurate risk assessment practices in clinical settings. They believe that this tool could play a significant role in reducing colorectal cancer rates among young individuals if validated successfully.