Younger age at screening links to lower CRC incidence
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Endoscopy in patients aged younger than 50 years decreased the incidence of colorectal cancer, according to study estimates reported at Digestive Disease Week.
“In contrast to an overall decline in CRC incidence in the U.S., there has been a dramatic increase in the incidence of CRC among younger adults. ... Recently, the American Cancer Society and the U.S. Preventive Services Task Force updated recommendations to initiate CRC screening at age 45 years, primarily based on modeling studies accounting for the growing CRC incidence among younger adults,” Wenjie Ma, D.Sc., clinical and translational epidemiology unit and division of gastroenterology at Massachusetts General Hospital and Harvard Medical School, and colleagues wrote. “However, to date, there is little empirical evidence evaluating the potential benefits of screening in younger populations.”
To investigate the association between endoscopies for CRC screening with subsequent risk for incident CRC, researchers analyzed 10,864 women aged 26 years to 46 years from the Nurses’ Health Study II. Participants reported whether they underwent sigmoidoscopy or colonoscopy every 2 years as well as the indication for the exam and information on CRC risk factors such as family history and lifestyle factors; researchers followed participants for diagnoses of polyps and CRC.
Over 24 years (2,051,949 person-years of follow-up), researchers documented 323 cases of CRC; endoscopy in patients younger than 50 years correlated with a reduced risk for incident CRC. Compared with endoscopy-naive participants, multivariate hazard ratio for incident CRC in those who underwent endoscopy for screening and in those who underwent endoscopy for symptoms was 0.39 (95% CI, 0.23-0.68 and 95% CI, 0.22-0.66, respectively). Further hazard ratios for CRC diagnosis before age 55 years was 0.5 (95% CI, 0.26-0.97) for screening and 0.39 (95% CI, 0.19-0.79) for symptoms. Researcher noted screening before age 50 may prevent 57% of incident CRCs (95% CI, 40-70).
“Our findings support the new guidelines that recommend screening for CRC at age 45,” Ma concluded.
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Ma W, et al. Abstract 874. Presented at: Digestive Disease Week; May 21-23, 2021 (virtual meeting).
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