Younger Americans Not Seeking Colorectal Cancer Screening Despite Being Eligible

Americans between the ages of 50 and 54 were a third less likely than Americans in their seventies to seek out colorectal cancer screening, according to a new study.

Colorectal cancer rates are rising in younger Americans and several high-profile deaths from the disease in younger people, including Hollywood actor Chadwick Boseman, have led to calls from experts for more young people to undergo screening. Screening can lead to early diagnosis of pre-cancerous growths in the gut called polyps, which can often be surgically removed before they progress to cancer. The more advanced colorectal cancer is, the slimmer the chances of surviving it, for example, people with stage 4 colorectal cancer have just a 14% chance of being alive 5 years after diagnosis.

The study published in the journal Cancer Epidemiology, Biomarkers & Prevention led by researchers from the University of Texas, involved data from more than 80,000 people. It showed that although colorectal cancer screening rates increased over time in all age groups, people between the age of 50-54 had the slowest increase, leaving over half not undergoing the recommended screening.

“Across all age groups, colorectal cancer screening participation remains below national goals, and the benefits of screening are not equally realized across populations,” said Caitlin Murphy, PhD, MPH, an associate professor at the University of Texas Health School of Public Health in Dallas.

As well as looking at screening take up by age, the study also looked at race and ethnicity as well as education levels, health insurance coverage and household income to see if they could spot any predictors of why people may or may not be getting screened. In the 50-54 age group, Hispanic individuals were 15.5% less likely than white individuals to access screening and Asian people were 17.7% less likely to get screening. Those who were uninsured in this age group were also 43.4% less likely to have screening than people who had military insurance.

The study was conducted using data up to 2018, but in 2021, the guidelines for screening were updated to mean that even younger people are now eligible for colorectal cancer screening from the age of 45. The change was made in response to an increase of colorectal cancer cases in younger people, with cases in people between the ages of 45 and 54 accounting for almost 10% of all colorectal cancer deaths in recent years.

Murphy believes that the same disparities identified in the study may also affect people in the newly-eligible 45-49 age group and may lead to low levels of screening.

“Extra care must be taken to ensure that expanding screening to younger ages does not negatively impact efforts to eliminate disparities in colorectal screening and outcomes, nor jeopardize efforts to increase screening initiation among older adults who remain unscreened,” said Murphy.

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