Summary：Vietnamese colonoscopy study reveals alarming rise in colorectal cancer risk factors **Introduction

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Vietnamese colonoscopy study reveals alarming rise in colorectal cancer risk factors

**Introduction**
A recent multicenter colonoscopy investigation in Vietnam has uncovered a troubling increase in colorectal cancer (CRC) risk factors among asymptomatic adults. While earlier research focused on patients presenting with lower‑gastrointestinal symptoms, this study deliberately recruited individuals without overt complaints to gauge the true burden of precancerous lesions in the general population. Conducted between January 2022 and December 2023 across three major hospitals in Hanoi, Ho Chi Minh City, and Da Nang, the project enrolled 4,215 participants aged 40–75 who underwent screening colonoscopy after a negative fecal immunochemical test (FIT).

**Key Developments**
Findings showed that 18.4 % of the asymptomatic cohort harbored at least one adenomatous polyp, with 4.2 % displaying advanced adenomas—lesions strongly linked to future malignancy. Notably, the prevalence of advanced adenomas rose sharply among participants aged 50–59 (6.1 %) compared with those 40–49 (2.8 %). Lifestyle‑related risk factors were markedly common: 34 % reported regular consumption of processed meats, 27 % led sedentary lives, and 22 % were obese (BMI ≥ 30). Smoking and alcohol use, though lower than in Western cohorts, still appeared in 15 % and 12 % of subjects, respectively. Multivariate analysis identified age (>55 years), obesity, and high processed‑meat intake as independent predictors of advanced adenoma (adjusted odds ratios ranging from 1.8 to 2.4).

**Industry Analysis**
The results underscore a growing mismatch between Vietnam’s current screening guidelines—which recommend fecal testing only for symptomatic individuals—and the silent emergence of neoplastic changes. Health‑policy experts warn that reliance on symptom‑driven referrals may miss a substantial at‑risk segment, delaying diagnosis until cancers reach advanced stages. Economically, treating late‑stage CRC costs the Vietnamese health system an estimated US$12,000 per case, whereas preventive colonoscopy and