Related Experiment Video
Updated: Jul 3, 2026
03:43
Structured Approach to Colonoscopy Technique Optimization: A Single-Center Experience with Novice Endoscopists
Published on: July 11, 2025
Colonoscopy utilization and persistent disparities in early onset colorectal cancer: A multistate, multi-institution
Brian E Diskin1, Robyn A Husa2, Saul A Castro2
1Division of Surgical Oncology, Saint John's Cancer Institute, Providence Saint John's Health Center, Santa Monica, CA.
Surgery
|July 1, 2026
Summary
Rising early-onset colorectal cancer (CRC) diagnoses are not explained by increased colonoscopy use alone. Disparities persist, especially in minority groups, indicating a need for targeted strategies beyond screening access.
Area of Science:
- Oncology
- Public Health
- Health Disparities
Background:
- The increasing burden of early-onset colorectal cancer (CRC) necessitates understanding its drivers, including screening trends and epidemiologic shifts across diverse populations.
- It remains unclear if rising CRC incidence in younger individuals is due to increased colonoscopy use or a genuine increase in disease prevalence.
- Analysis is needed to explore racial/ethnic disparities in CRC trends and risk factors.
Purpose of the Study:
- To analyze predictors of early-onset CRC.
- To examine temporal trends in colonoscopy utilization from 2017-2023.
- To assess the correlation between colonoscopy use and early-onset CRC diagnoses, and evaluate differential risks based on healthcare engagement and ethnicity.
Main Methods:
- A retrospective matched nested case-control study involving 2,776 patients (1,388 early-onset CRC, 1,388 controls).
- Conditional multivariable logistic regression identified independent risk factors for CRC.
- Colonoscopy utilization and CRC diagnoses were indexed to track trends by race/ethnicity, with correlation and predicted risk analyses performed.
Main Results:
- Colonoscopy use increased significantly from 2017-2023, particularly in the 41-50 age group, yet early-onset CRC diagnoses rose disproportionately (93% increase in 41-50 year olds).
- Significant racial/ethnic disparities were observed, with marked increases in CRC diagnoses among Black (300%), Hispanic (192%), and Asian (144%) patients compared to 2017.
- Independent risk factors included iron-deficiency anemia, former alcohol use, and specific racial/ethnic groups (American Indian/Alaska Native, Black, Hispanic). Hispanic/Latino patients had worse survival outcomes. Increased healthcare utilization correlated with lower CRC odds, but this effect was attenuated in Hispanic patients.
Conclusions:
- Despite increased colonoscopy utilization, disparities in early-onset CRC diagnosis and outcomes persist, particularly for ethnic minorities.
- Improvements in screening access alone are insufficient to address these inequities.
- Targeted, equity-focused strategies beyond screening are crucial to mitigate early-onset CRC disparities.
Related Concept Videos
01:25Endoscopic Procedures II: Colonoscopy
The colon, or large intestine, is the final segment of the digestive system. Its primary functions include absorbing water and vitamins produced by gut bacteria and transforming waste from liquid to solid to form stool. In adults, the large intestine is approximately 5 feet long and consists of four main sections:
01:26Imaging Studies III: Gastrointestinal Motility Studies and Virtual Colonoscopy
This lesson explores three gastrointestinal imaging techniques: radionuclide testing, colonic transit studies, and virtual colonoscopy.
Radionuclide Testing
Radionuclide testing is a sophisticated medical technique for assessing gastrointestinal motility. It focuses on gastric emptying and colonic transit time. Radioactive markers track the movement of food through the digestive system, providing insights into gastrointestinal disorders.
In gastric emptying studies, a meal's liquid and solid...
Radionuclide Testing
Radionuclide testing is a sophisticated medical technique for assessing gastrointestinal motility. It focuses on gastric emptying and colonic transit time. Radioactive markers track the movement of food through the digestive system, providing insights into gastrointestinal disorders.
In gastric emptying studies, a meal's liquid and solid...