Older Age Is Associated with a Higher Incidence Colonic Adenomas During Colonoscopy
Bibliographic record
Abstract
Purpose: Our nations life expectancy is growing. It is projected to increase from 76.0 years in 1993 to 82.6 years in 2050. Older age is also shown to be associated with increased risk of multiple cancers including colorectal cancer (CRC). The purpose of our study is to report the association of older age with polyp and adenoma detection during colonoscopy. Methods: We prospectively enrolled 430 patients undergoing outpatient colonoscopies from March to July 2011. We collected data using medical records and questionnaires participants completed before colonoscopy. Polyp detection rate (PDR) was calculated from colonoscopy reports, and adenoma detection rate (ADR) was calculated from pathology reports. Age was categorized in three groups: <55 years of age, 55-65 years of age, and >65 years of age. Pearson's Chisquare or Kendall's tau-b tests were used to identify factors associated with detection of polyps and adenomas. Multiple multivariate analyses were performed to determine independent predictors for polyp and adenoma detection. Results: The mean age was 60.4 (24-84) including 30.9% >55 years of age, 39.3% 55-65 years of age, and 29.8% >65 years of age. 211 (49.1%) participants were male. 223 (48.1%) were screening colonoscopies (no prior colonoscopy, the last colonoscopy ≥ 10 years, or no symptoms). 87.3% of the bowel preparations were excellent or good (total Ottawa score 4 or less). 35.5% of all adenomas were in the right colon (cecum and ascending colon). The overall PDR was 57.4% and the ADR was 44%. In a univariate analysis, age was significantly associated with PDR and ARD in the whole colon as well as the right colon for all patients (p≤0.001 for all). After adjusting for gender, BMI, race, history of colonoscopy, quality of bowel prep (Ottawa score), and comorbidities (diabetes, stroke), age remained independently associated with polyp and adenoma detection in the entire colon (p=0.001 for both). In subgroup analysis, age>65 was associated with a much higher PDR and ADR than age 55-65 while compared with age< 65 years (p=0.003 and p<0.001 vs. 0.949 and p=0.304 respectively). Conclusion: Older age is strongly associated with a higher PDR and ADR after adjusting for gender, BMI and quality of bowel preparation. Our finding correlates strongly with the known risk of increase colorectal cancer in older patients. Age >65 years is also associated with a much higher risk of adenoma than age 55-65 years in all our patients. This may have implications in stratifying the highest risk population for CRC especially in areas where resources are limited.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".