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Knowledge, Attitudes, and Perceptions Around Colorectal Cancer Screening and Risk Among 20-49 Year Olds
Timothy Yen1, Paul C Schroy2, Heather Hampel3
1Division of Gastroenterology, Loma Linda University Health, Loma Linda, CA, USA.
Digestive Diseases and Sciences
|August 3, 2025
Summary
Younger adults show low awareness of colorectal cancer screening guidelines and fear screening procedures. Tailored education is needed to improve screening uptake in this age group.
Area of Science:
- Oncology
- Public Health
- Health Behavior
Background:
- Colorectal cancer (CRC) incidence is rising in individuals under 50.
- Screening rates for CRC remain suboptimal, with diagnostic delays common for those with red flag symptoms.
Purpose of the Study:
- To assess knowledge of blood in stool as a CRC red flag among younger adults (20-49 years old).
- To evaluate fear of screening procedures and trust in doctors within this demographic.
- To identify factors associated with CRC screening knowledge and attitudes.
Main Methods:
- Analysis of a nationwide exploratory survey of 747 individuals aged 20-49.
- Multivariable logistic regression used to assess factors associated with knowledge, fear, and trust.
- Adjustment for false discovery rate in statistical analysis.
Main Results:
- Only 16% knew CRC screening should start at age 45, despite 76% agreeing on the need for screening.
- Nearly half of participants feared CRC screening tests; 56% would discuss rectal bleeding with a provider.
- Social networking site use was linked to accurate knowledge of blood in stool as a CRC red flag (OR 2.02).
Conclusions:
- Significant knowledge gaps and low intention toward CRC screening exist in adults aged 20-49.
- Trust in health information varies greatly by source, with medical providers being most trusted.
- Future research should focus on tailored educational strategies for younger audiences to improve screening rates.
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