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Younger first-degree relatives of colorectal cancer patients less likely to have colonoscopy
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While colonoscopy screening rates have increased 5-fold in the past 10 years, first-degree relatives of colorectal cancer patients aged younger than 50 years are less likely to have a colonoscopy than adults aged 50 or older, according to recent study data.
“The 4.3% annual decline in incidence among adults aged 50 or older is marred by the concurrent 1.8% annual increase among adults younger than 50; an increase in [colorectal cancer] incidence of 28% to 46% is anticipated for this younger age group by 2030,” the researchers wrote.
Sudha Xirasagar
Aiming to learn whether younger first-degree relatives of colorectal cancer patients are undergoing screening colonoscopy according to the current guideline from the American College of Gastroenterology, which recommends screening begin at age 40 if the relative is diagnosed before age 60, Sudha Xirasagar, PhD, MBBS, from the department of health services policy and management, University of South Carolina, Arnold School of Public Health, and colleagues performed a U.S. population-based study using data from the 2005 and 2015 National Health Interview Survey.
They identified 26,064 eligible respondents (n = 13,731 in 2005; n = 12,333 in 2010) for whom the colonoscopy rate was 16.5% in 2005 vs. 49.1% in 2010. Among the 2,470 respondents who reported a family history of colorectal cancer, 45.6% underwent colonoscopy (25.2% in 2005 and 65.8% in 2010 compared with 19% and 57%, respectively, for non-first-degree relatives).
Among first-degree relatives aged 40-49 years the colonoscopy rate tripled from 2005-2010, though the rate was 38.3% compared with 69.7% for those aged 50 years or older.
First-degree relatives were 70% more likely to have a colonoscopy compared with non-first-degree relatives (adjusted odds ratio [AOR] = 1.7; 95% CI, 1.5-1.9), however, those aged 40-49 years were less likely to have a colonoscopy compared with those aged 50-64 years (AOR = 2.6; 95% CI, 2-3.3) or those aged older than 65 years (AOR = 3.6; 95% CI, 2.7-4.7). Having private (AOR = 3.3; 95% CI, 2.8-3.9) or public insurance (AOR = 3.4; 95% CI, 2.8-4.1) increased the likelihood of having colonoscopy by about threefold compared with those who were uninsured.
“The key finding of this study is that first-degree relatives younger than the conventional screening age of 50 were less likely than adults aged 40 or older to have had a colonoscopy,” the researchers concluded. “Our study shows the need for increasing screening rates in this subgroup, particularly first-degree relatives younger than 50 because of the recent increase in [colorectal cancer] among American adults in this age group.” – by Adam Leitenberger
Disclosure: The researchers report no relevant financial disclosures.
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