# Effectiveness of Colonoscopy Screening in Identifying Colorectal Cancer in Young Patients: A Retrospective Cohort Study in a Single Saudi Institution

## TL;DR

This study found that 1% of young patients in Saudi Arabia had colorectal cancer, highlighting the need for early screening when symptoms appear.

## Contribution

The study provides new evidence on CRC incidence in young, low-risk populations in Saudi Arabia.

## Key findings

- 3 out of 312 young patients (0.96%) were diagnosed with stage III colorectal cancer.
- Most patients had symptoms like rectal bleeding and abnormal bowel habits before colonoscopy.
- Early evaluation is recommended for young patients showing warning signs of CRC.

## Abstract

Background

Globally, the incidence of colorectal cancer (CRC) is rising, with a notable increase seen in younger people. When detected early, CRC is a relatively curable illness with a 90% survival rate. Only those over 50 are recommended to be screened for colorectal cancer in those at average risk. The purpose of this study is to determine the likelihood of cancer in the community and to examine the dubious clinical signs that lead to colonoscopy in younger patients.

Methods

This retrospective cohort study analyzed medical records of patients aged ≤35 years who underwent colonoscopy between January 2021 and December 2024 at Doctor Soliman Fakeeh Hospital and had no prior rationale for early bowel cancer screening.

Results

A total of 312 participants had colonoscopies during the research period. Of them, 293 (93.9%) had symptoms before colonoscopy, such as abdominal pain (9.9%), symptomatic anemia (7.3%), abnormal bowel habits (22.9%), and rectal bleeding (53.8%). Three individuals (0.96%) with invasive cancer were identified to have stage III disease based on the histological analysis.

Conclusion

The incidence of CRC in a community that is thought to be low-risk is about 1%. Younger patients typically have a low suspicion of cancer, therefore delays in their inquiry could lead to a more advanced diagnosis than initially assumed. When a young patient shows any warning signs, it is therefore recommended that they be evaluated immediately.