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Data Support Lowering Age for CRC Screening to 45 Years

FRIDAY, Jan. 14, 2022 -- The prevalence of colorectal neoplasia observed among younger outpatients undergoing colonoscopies supports the recommendation to lower the screening age for colorectal cancer (CRC) to age 45 years, according to a study published online Jan. 4 in Gastroenterology.

Parth D. Trivedi, M.D., from the Icahn School of Medicine at Mount Sinai in New York City, and colleagues examined the prevalence of and risk factors for colorectal neoplasia among patients aged 18 to 54 years by analyzing a nationally representative dataset of almost 3 million outpatient colonoscopies in the GI Quality Improvement Consortium Registry.

The researchers found that the odds of advanced premalignant lesions (APLs) and CRC were increased in association with increasing age, male sex, White race, family history of CRC, and examinations to investigate bleeding or to screen. Among patients aged 45 to 49 years, 32, 7.5, and 0.58 percent had any neoplasia, APLs, and CRC, respectively; those aged 40 to 44 years had rates that were almost as high. Asians and American Indian/Alaskan Natives had higher rates of APLs, but rates were lower for Blacks and Hispanics compared with Whites. Between 2014 and 2020, the prevalence of any neoplasia and APLs increased gradually among all age groups.

"Because precancerous lesions are not reportable to regional or national health agencies, we have not had this degree of information to guide our recommendations," a coauthor said in a statement. "Our study provides an important piece of the puzzle and supports the recommendation changing the screening age to 45."

Two authors disclosed financial ties to biotechnology companies.

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