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Colorectal Cancer Screening Completion and Yield in Patients Aged 45 to 50 Years : An Observational Study
Theodore R Levin1, Christopher D Jensen2, Natalia Udaltsova2
1Division of Research, Kaiser Permanente Northern California, Oakland, California, and Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California (T.R.L.).
Annals of Internal Medicine
|November 12, 2024
Summary
Colorectal cancer (CRC) screening completion and yield are similar for individuals aged 45–49 and 50 years. These findings support the updated guideline recommending CRC screening initiation at age 45.
Area of Science:
- Gastroenterology
- Oncology
- Preventive Medicine
Background:
- Current guidelines recommend initiating colorectal cancer (CRC) screening at age 45, a shift from the previous age of 50.
- Limited data exist on screening completion rates and diagnostic yield in the 45-49 age group.
Purpose of the Study:
- To compare fecal immunochemical test (FIT) completion and yield between patients aged 45-49 and those aged 50 years.
- To evaluate the effectiveness of early CRC screening initiation.
Main Methods:
- A retrospective cohort study was conducted using data from Kaiser Permanente.
- FIT kits distributed between January and September 2022 were analyzed.
- Outcomes included FIT completion, positivity, colonoscopy follow-up, and cancer detection rates.
Main Results:
- FIT completion was slightly higher in the 45-49 age group (38.9%) compared to the 50-year-old group (37.5%).
- FIT positivity was lower in the younger group (3.6% vs. 4.0%), with similar rates of colonoscopy follow-up.
- Detection rates for adenomas and advanced histology were comparable, and colorectal cancer detection was similar (2.8% vs. 2.7%).
Conclusions:
- The study indicates comparable FIT completion and yield rates between individuals aged 45-49 and 50 years.
- These findings support the recommendation to begin colorectal cancer screening at age 45.
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