Key takeaways:
- Screening colonoscopy findings didn’t differ considerably between adults aged 45 to 49 years and people aged 50 to 54 years.
- Prevalence of any adenoma was barely decrease within the youthful group (35.4% vs. 40.8%).
The prevalence of superior precancerous polyps and colorectal most cancers amongst adults aged 45 to 49 years present process preliminary screening colonoscopy was just like that of adults aged 50 to 54 years, in keeping with analysis revealed in JAMA.
These findings strengthen proof in assist of the up to date U.S. Preventive Providers Activity Drive CRC screening tips advising an earlier screening age of 45 years, in keeping with lead creator Jeffrey Ok. Lee, MD, MPH, a gastroenterologist and analysis scientist at Kaiser Permanente Division of Analysis.
Information derived from Lee JK, et al. JAMA. 2025;doi:10.1001/jama.2025.7494.
Jeffrey Ok. Lee
“Though we don’t absolutely perceive why colorectal most cancers charges are rising in younger adults, it’s critically essential that adults 45 years of age and older get screened for colorectal most cancers,” Lee advised Healio. “As well as, docs ought to take into account additional workup for younger grownup sufferers who’re experiencing persistent signs of rectal bleeding, belly ache, modifications of their bowel habits or unintentional weight reduction, as these may be signs of colorectal most cancers.”
With restricted data on screening colonoscopy neoplasia yields amongst youthful adults following the up to date tips, Lee and colleagues in contrast findings amongst adults aged 45 to 49 years and 50 to 54 years within the Kaiser Permanente Northern California well being system, which gives care to greater than 4.5 million people within the area.
“We believed it was essential to measure the real-world prevalence of precancerous polyps and colorectal most cancers after the USPSTF tips have been carried out in a community-based setting that’s broadly consultant of the overall inhabitants,” Lee mentioned.
The examine included 12,031 adults (aged 45-49 years, n = 4,380; aged 50-54 years, n = 7,651; 47.3% girls; 42.8% white; median BMI, 26.5 kg/m2) who underwent their first screening colonoscopy between 2021 and 2024. Greater than three-quarters (78.7%) had a Charlson comorbidity rating of zero, and 24% had a historical past of smoking.
The researchers excluded people with a historical past of inflammatory bowel illness, household or private historical past of CRC or adenoma, incomplete screening colonoscopy or a diagnostic indication.
Outcomes included CRC, superior serrated lesion or adenoma, any sessile serrated lesion or any adenoma.
The investigators used Poisson regression to estimate threat ratios by age group, with the older group serving as reference, and adjusted the fashions for intercourse, race and ethnicity, Charlson comorbidity rating, BMI and smoking historical past.
General, screening colonoscopy outcomes have been barely much less frequent within the youthful vs. older group, reaching statistical significance just for any adenoma (35.4% vs. 40.8%; adjusted RR = 0.86; 95% CI, 0.82-0.9).
No different important variations in colonoscopy findings have been noticed between age teams, together with superior adenoma (3.8% vs. 4.1%; aRR = 0.9; 95% CI, 0.75-1.09), superior serrated lesion (1.5% vs. 1.8%; aRR = 0.85; 95% CI, 0.63-1.14), any sessile serrated lesion (10.2% vs. 10.4%; aRR, 0.98; 95% CI, 0.88-1.1) and CRC (0.1% vs. 0.1%; aRR = 0.56; 95% CI, 0.15-2.07).
Moreover, except any adenoma, the researchers discovered no important variations within the prevalence of neoplasia between age teams by intercourse.
“We discovered a barely decrease prevalence of any adenoma in these ages 45 to 49 than in these ages 50 to 54,” Lee advised Healio. “That is in line with a previous screening examine that was performed at a university-based medical heart. Our findings are additionally just like a big examine of adenoma detection charges on a screening colonoscopy that in contrast individuals aged 45 to 49 with these aged 50 to 54. Each prior research have been performed previous to the change in USPSTF tips.”
Lee famous that though the proportion of Asian people on this examine (30.4%) was increased than the overall inhabitants, it’s not a limitation that impacts the worth of the outcomes.
“Beginning colorectal most cancers screening at age 45 can discover precancerous polyps and cancers,” he mentioned.
For extra data:
Jeffrey Ok. Lee, MD, MPH, may be reached at Susan.L.Rochman@kp.org.
Sources/Disclosures
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Disclosures:
Lee reviews no related monetary disclosures. Please see the examine for all different authors’ related monetary disclosures.
