Research supports recommendations to lower colorectal screening age to 45

May 25, 2021

AMSURG, a division of Envision Healthcare and Icahn School of Medicine at Mount Sinai Health System, released new findings on colorectal cancer (CRC), which support several recommendations to lower the screening age from 50 to 45 for people who are at average risk for CRC, reported Mount Sinai.

The findings were presented at the Digestive Disease Week 2021 virtual scientific meeting on May 23. The Mount Sinai team analyzed approximately three million colonoscopies performed at more than 120 AMSURG ambulatory surgery centers across the country in the last six years. The study specifically looked at de-identified data from patients aged 18 to 54 who received a screening or diagnostic colonoscopy and were not undergoing a colonoscopy to monitor previously detected polyps, cancer, inflammatory bowel disease or genetic conditions predisposing to cancer.

Results show:

·        Colorectal cancer was detected in 0.58 percent of patients aged 45 to 49 and in 0.53% of patients aged 40 to 44

·         Polyps that had the greatest possibility of becoming cancerous were found in 7.5% of patients aged 45 to 49 and in 5.8% of patients aged 40 to 44

·         A significant portion of patients had polyps present even if they did not have a documented family history of colorectal cancer

“These findings are significant and can make a meaningful difference in the healthcare system's ability to save patients’ lives. With early and routine colonoscopies, we can prevent polyps from becoming cancerous and even detect and remove cancerous polyps while giving patients a better chance of recovery and survival. These data support efforts to begin screening at age 45 and communicate the importance of on-time screening by early messaging to patients and providers,” said John Popp, MD, Medical Director for AMSURG.

Colorectal cancer is the second leading cause of cancer death in the U.S. and one of the most preventable. The incidence of CRC in patients under 50 has nearly doubled since the early 1990s. Consensus in the medical community is building that patients who are at average risk for CRC should begin screening at age 45.

“This study can inform additional research directed at CRC screening in younger populations. More importantly, it helps physicians inform patients about the importance of early screening several years before they reach screening age; we believe that this will encourage younger patients to get routine screenings on time, at the appropriate age, and with close attention to the individual’s risk factors and symptoms,” said primary investigator, Steven Itzkowitz, MD, Professor of Medicine, Oncological Sciences and Medical Education, and Director of the GI Fellowship Program at Icahn School of Medicine at Mount Sinai.

Risk factors include a family history of CRC or pre-malignant polyps, inflammatory bowel disease and lifestyle habits, such as diet, smoking and obesity. CRC also disproportionately impacts the Black community. While symptoms are not always easy to recognize, they can include a change in bowel habits, such as diarrhea and constipation. Additionally, rectal bleeding, abdominal discomfort or a feeling that the bowel does not completely empty can be a cause for concern. Individuals are urged to listen to their bodies and consult their physicians if they have questions or require medical care.

As a leading provider of colonoscopies, AMSURG submits a larger colonoscopy dataset than any provider to a national endoscopic registry called the GI Quality Improvement Consortium (GIQuIC). The AMSURG data reviewed for this study was obtained from the registry.

Mount Sinai has the release.