Colorectal Cancer Screening Effective for Patients Aged 45 to 50 Years

New research published in Annals of Internal Medicine supports the initiation of colorectal cancer (CRC) screening at age 45, showing comparable outcomes in screening completion and yield for patients aged 45 to 49 and those aged 50.

“The findings indicate that starting CRC screening at age 45 is feasible and can be effective,” the researchers stated. “This aligns with updated guidelines recommending earlier screening.”

The retrospective cohort study included 267,732 patients who received FIT kits: 213,928 aged 45 to 49 years and 53,804 aged 50 years. The researchers evaluated data from Kaiser Permanente facilities in Northern California, Washington, and Colorado, analyzing outcomes of fecal immunochemical test (FIT) distribution and completion from January to September 2022. The study

FIT completion within 3 months was slightly higher in the 45 to 49 age group (38.9% vs. 37.5%; adjusted risk ratio [aRR], 1.05 [95% CI, 1.04 to 1.06]). However, in Colorado, the completion rate for the younger group was notably lower (30.7% vs. 40.2%; aRR, 0.77 [CI, 0.73 to 0.80]).

FIT positivity rates were lower in patients aged 45 to 49 (3.6% vs. 4.0%; aRR, 0.91 [CI, 0.84 to 0.98]), and the rate of colonoscopy following a positive FIT was similar between groups (64.9% vs. 67.4%; aRR, 1.00 [CI, 0.94 to 1.05]). The younger group had a lower adenoma detection rate (58.8% vs. 67.7%; aRR, 0.88 [CI, 0.83 to 0.95]), but yields for advanced adenomas, high-grade dysplasia, sessile serrated lesions, and CRC were comparable between the age groups.

The study acknowledged that the limited number of neoplasia events resulted in wide confidence intervals, suggesting some caution in interpreting the data.

“Overall, the results reinforce that starting CRC screening at age 45 is reasonable and yields results similar to those in patients aged 50,” the authors concluded.

Reference:

Levin TR, Jensen CD, Udaltsova N, et al. Colorectal cancer screening completion and yield in patients aged 45 to 50 years: an observational study. Ann Intern Med. Published online October 22, 2024. doi:10.7326/M24-0743