More Adults Aged 45–49 Being Screened, Diagnosed With Colon Cancer: Studies

Expanded screening has been implemented in recent years.

Stool test and colonoscopy are common colorectal cancer screening options. Lost Mountain Studio, Photoroyalty/Shutterstock

More younger adults are being screened for and diagnosed with colon cancer, according to studies published on Aug. 4.

Colon cancer cases among adults aged 45 to 49 increased 12 percent annually from 2019 through 2022, up from an increase of 1.1 percent annually from 2004 through 2019, researchers reported in one of the studies.

Smaller increases for other age ranges—1.6 percent annually for adults aged 20 to 39 since 2004, 2 percent annually for adults aged 40 to 44 since 2012, and 2.6 percent for adults aged 50 to 54 since 2012—were also recorded.

Elizabeth Schafer, with the American Cancer Society’s Surveillance and Health Equity Science Department, and co-authors with the society said the sharper jump among adults aged 45 to 49 “likely reflects diagnosis of prevalent asymptomatic cancer through first-time screening due to recommendations for adults to begin screening at age 45 years instead of 50 years.”

The society in 2018 advised starting screening for colon cancer, also known as colorectal cancer, at age 45. The U.S. Preventive Services Task Force issued the same recommendation in 2021.

The study, published by the Journal of the American Medical Association, analyzed data from 21 different registries from the government-supported Surveillance, Epidemiology, and End Results program, which collects data on cancer incidence and survival rates.

Researchers listed no conflicts of interest. They said the study’s limitations included potential influence from the COVID-19 pandemic.

In a research letter also published by the Journal of the American Medical Association, Schafer and other researchers with the American Cancer Society said that a survey showed that colon cancer screening increased from 20.8 percent in 2019 to 33.7 percent in 2023 among American adults aged 45 to 49.

They also found that screening remained about the same for other age groups.

“It’s not only thrilling to see the increase in colorectal cancer screening among younger adults, but also how it likely ties into rises in earlier stage diagnosis as noted in the other ... paper,” Jessica Star, an associate scientist with the American Cancer Society and lead author of the study, said in a statement. “However, we still have a long way to go. Screening for colorectal cancer in ages 45-49 remains suboptimal and has not increased equitably by both educational attainment and insurance status.”

Among the limitations of that paper, for which no conflicts of interest were reported, were potentially inaccurate recall and possible overestimation.

Dr. Artin Galoosian with the University of California–Los Angeles, and a separate group of researchers, said in a third paper released by the same journal on Monday that adults aged 45 to 49 were more likely to appear for colon cancer screening if they received unsolicited mailers, compared to three other message-based strategies.

The researchers completed a randomized clinical trial with about 20,500 adults to test which one yielded the highest percentage of screenings. The three non-mailer strategies utilized messages with different focuses, conveyed through a patient portal.

The researchers advised future researchers to look at how to best tailor prepaid mailers to boost screening numbers.

Conflicts of interest included grants from the National Science Foundation. The trial was run out of a single center, and researchers did not assess the cost-effectiveness of the mailers, which cost $8 each.