New Data Support Earlier Colorectal Cancer Screening

As colorectal cancer incidence decreases in older adults, incidence in people younger than 50 is on the rise.

“Lower gastrointestinal screening endoscopy has the potential to reduce cancer incidence by identifying a treatable premalignant condition (ie, adenomatous or serrated polyps) and to reduce cancer mortality by enabling diagnosis of malignant disease at an earlier stage,” experts explained in a recent JAMA Oncology editorial.

Although the American Cancer Society and the US Preventive Services Task Force have issued a qualified recommendation to lower the colorectal cancer screening age to 45 years for people at average risk, the recommendation was based on microsimulation models of screening in a hypothetical cohort of 40-year-olds rather than on clinical evidence.

However, a recent study in JAMA Oncology provides new empirical data supporting the utility of earlier screening, the editorial pointed out. The results stemmed from an analysis of data for 111,801 women with more than 2 decades of follow-up in the Nurses’ Health Study II.

“The authors found that compared with no endoscopy, initiation of endoscopy before 50 years of age was associated with a reduced risk of colorectal cancer,” the editorial reported; “they also found a greater reduction in the absolute risk of colorectal cancer through 60 years of age associated with endoscopy initiation before 50 years of age compared with initiation at 50 years of age or later.”

—Jolynn Tumolo

Reference:
Calip GS, Meropol NJ, Weinberg DS. Colorectal cancer incidence among adults younger than 50 years-understanding findings from observational studies of lower gastrointestinal endoscopy. JAMA Oncol. Published ahead of print May 5, 2022.