The aim of this study was to evaluate the clinicopathologic characteristics of the colorectal polyps in people under 50 years old.

From January to August 2001, the colonoscopic finding and pathologic reports of 527 patients under 50 years old who underwent colonoscopy were reviewed retrospectively. The advanced polyp was defined as an adenoma more than 10mm in diameter or with the histology of villous or high grade dysplasia.

Total 94 colonic polyps(17.8%) were analyzed. On age distribution, 65 cases(69.1%) were in forth decade, 25 cases(26.6%) in third decade. Abdominal pain(29.8%) was the most common cause of taking the colonoscopic examination followed by rectal bleeding(18.1%), asymptomatic screening(12.7%). Rectosigmoid area was the most common site of polyps in 63.8%. On the pathologic review, adenoma was found 55.1%, inflammatory polyp 38.5% and hyperplastic polyp 6.4%. Advanced adenomas were 17.9%(17/156) and adenomas with focal carcinomatous changes were 1.9%(3/156). Patients who had symptoms of abdominal pain or rectal bleeding, multiple polyps or familial history of colorectal cancer had a higher prevalence of advanced adenoma than that of non-advanced adenoma(p<0.05).

This study showed that major symptoms of patients with advanced polyps under 50 years old were abdominal pain and rectal bleeding. The symptoms, multiplicity of polyp and family history were important indicator of advanced polyps. Further study was needed for reasonable indication and cost effectiveness for colonoscopic examination in young age people.