Prevalence of colonoscopy before age 50

Area of Science:

• Gastroenterology
• Preventive Medicine
• Public Health

Background:

• Colorectal cancer (CRC) screening is recommended to begin at age 50 for average-risk individuals.
• Understanding the prevalence of colonoscopy before age 50 is crucial for evaluating current screening practices and potential shifts in guidelines.

Purpose of the Study:

• To describe the prevalence of colonoscopy performed before age 50.
• To analyze trends and variations in early colonoscopy receipt among different demographic groups.

Main Methods:

• Analysis of administrative health records for 204,758 individuals aged 50, examining colonoscopies between ages 40-49.
• Utilized backward recurrence time models to assess trends and sex-based variations.
• Employed logistic regression on 2010 National Health Interview Survey (NHIS) data (27,157 respondents aged 40-49) to explore associations with sex, race/ethnicity, and geography.

Main Results:

• Approximately 5% of the health plan cohort underwent colonoscopy before age 50.
• Early colonoscopy rates significantly increased from 1999 to 2010 (p<0.0001).
• Women were more likely to have early colonoscopies than men (RR=1.9). Early colonoscopy was also more prevalent in the East Coast compared to West Coast/Hawaii plans and in Northeastern residents compared to Western residents.

Conclusions:

• Colonoscopy before age 50 is an increasingly common practice.
• The findings suggest a growing trend of early colorectal cancer screening, necessitating further investigation into its drivers and implications.