Document Type

Article

Publication Date

6-2026

Identifier

DOI: 10.1111/jgh.70408

Abstract

The rising incidence of early-onset colorectal cancer has renewed attention to colorectal adenomas in adolescents and young adults (AYA), although these lesions remain rare and poorly characterized in adolescents. Lack of age-specific guidance creates uncertainty regarding genetic evaluation, surveillance intervals, and long-term management when these lesions are identified in adolescents. This narrative review synthesizes current evidence and expert perspective on epidemiology, evaluation, endoscopic management, surveillance, genetic considerations, and psychosocial implications of incidentally identified colorectal adenomas across the AYA spectrum, with emphasis on adolescents as a distinct clinical population. Available data largely derive from adults aged 20-49 years but suggest that adenomas in adolescents are uncommon and more likely to prompt evaluation for hereditary colorectal cancer syndromes. Accordingly, adolescents with incidental colorectal adenomas should be referred for genetic counseling, with consideration of multigene panel testing, even in the setting of isolated lesions. Endoscopic management generally parallels adult practice, and young age alone does not appear to increase risk of metachronous advanced neoplasia. These findings support guideline-concordant surveillance without routine interval shortening when accurate polyp size assessment and confident complete resection are achieved, although adolescent-specific evidence remains limited. We propose a pragmatic clinical management algorithm integrating adenoma features, genetic risk assessment, and surveillance planning to support consistent, evidence-informed care in this understudied population.

Journal Title

Journal of gastroenterology and hepatology

Volume

41

Issue

6

First Page

1743

Last Page

1750

MeSH Keywords

Humans; Colorectal Neoplasms; Adenoma; Adolescent; Incidental Findings; Genetic Testing; Genetic Counseling; Age Factors; Young Adult; Colonoscopy; Adult

PubMed ID

42031684

Keywords

adenomatous polyps; adolescent; colonoscopy; colorectal neoplasms; genetic counseling

Comments

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Publisher's Link: https://onlinelibrary.wiley.com/doi/10.1111/jgh.70408

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