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

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.