{
  "abstract": "9Objective: To characterise age-related gradients in colorectal lesion severity and prespecified high-risk endoscopic features in a lesion-confirmed screening colonoscopy cohort and to evaluate an investigator-defined red-flag composite as an exploratory marker of advanced pathology. Helicobacter pylori was assessed as a secondary exposure.\n\nMethods: This retrospective cohort included 291 participants with histologically confirmed lesions in four age groups (36–45, 46–55, 56–65 and 66–72 years). Logistic regression evaluated predictors of advanced neoplasia (high-grade dysplasia [HGD] or adenocarcinoma); adenocarcinoma-only and age × H. pylori interaction analyses were exploratory because events were sparse.\n\nResults: With advancing age, body mass index, H. pylori positivity, adenoma, sessile serrated lesions, HGD, adenocarcinoma and high-risk endoscopic features increased, whereas hyperplastic polyps decreased (all P < 0.05). Age (per 10 years), male sex, H. pylori positivity, lesion size ≥10 mm, proximal location and JNET 2B/3 pattern were independently associated with advanced neoplasia. Red-flag positivity (≥2 of four features) increased from 5.2% to 32.7% and enriched for adenocarcinoma, although positive predictive values were imprecise and non-monotonic.\n\nConclusions: Colorectal lesion severity and high-risk endoscopic features showed an age-related gradient. The red-flag composite is an exploratory descriptive construct, not a validated predictive score. H. pylori findings, especially interaction analyses, are hypothesis-generating and require prospective validation.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Gastroenterology, Beijing Genertec Aerospace Hospital , ,",
    "Department of Health Management, Beijing Genertec Aerospace Hospital , ,",
    "Department of Gastroenterology, Beijing Renhe Hospital , ,",
    "Department of Internal Medicine, Beijing Tongzhou District Maternal and Child Health Care Hospital , ,",
    "Department of General Practice, Beijing Daxing District Jiugong Hospital , ,",
    "Department of Gastroenterology, Xuanwu Hospital, Capital Medical University , ,"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 12,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Lina Du"
    },
    {
      "affs": [
        1
      ],
      "name": "Jingzhi Su"
    },
    {
      "affs": [
        2
      ],
      "name": "Jihua Dai"
    },
    {
      "affs": [
        0
      ],
      "name": "Peipei Pu"
    },
    {
      "affs": [
        0
      ],
      "name": "Li Meng"
    },
    {
      "affs": [
        0
      ],
      "name": "Feiyan Zhao"
    },
    {
      "affs": [
        0
      ],
      "name": "Lili Pang"
    },
    {
      "affs": [
        0
      ],
      "name": "Sizhu Li"
    },
    {
      "affs": [
        3
      ],
      "name": "Yanxia Zhang"
    },
    {
      "affs": [
        4
      ],
      "name": "Xin Rong"
    },
    {
      "affs": [
        5
      ],
      "name": "Huihong Zhai"
    },
    {
      "affs": [
        0
      ],
      "name": "Sufang Shen"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/c62b898ed0f8r.bib",
  "cited_by": 0,
  "doi": "10.3389/fonc.2026.1842525",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672195/?tool=EBI",
  "id": "c62b898ed0f8r",
  "issns": [
    "2234-943X"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13672195",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2730|Colorectal Cancer Screening and Detection"
    ]
  ],
  "openalex": "W7215118837",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672195/pdf/?tool=EBI",
  "pmcid": "PMC13672195",
  "pmid": null,
  "published": "2026-10-02",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/c62b898ed0f8r.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:18:25Z",
      "native_id": "PMC:PMC13672195",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13672195"
    },
    {
      "first_seen": "2026-10-30T12:20:13Z",
      "native_id": "10.3389/fonc.2026.1842525",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fonc.2026.1842525/full"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2730|Colorectal Cancer Screening and Detection",
      "subfield": "oncology"
    }
  ],
  "title": "Age-stratified gradients of colorectal neoplasia and an exploratory endoscopic red-flag composite in a lesion-confirmed screening colonoscopy cohort",
  "title_text": "Age-stratified gradients of colorectal neoplasia and an exploratory endoscopic red-flag composite in a lesion-confirmed screening colonoscopy cohort",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:13Z",
  "url": "https://research.draconitic.com/paper/c62b898ed0f8r",
  "venue": "Frontiers in oncology",
  "versions": []
}