• Posted October 4, 2024

Colonoscopies Among the Young Are on the Rise

Colon cancers are increasing among younger Americans, so much so that experts advised in 2021 that colonoscopy screening begin at the age of 45, not 50 as had been previously recommended.

Now, research shows the new guideline may have led to a tripling in the use of the gold-standard screen among folks ages 45 to 49.

Still, in terms of the absolute number of people screened, colonoscopy rates remain too low, according to study senior author Xiaomei Ma.

“Although it is encouraging to observe a three-fold increase in colorectal cancer screening among the age group of 45 to 49 years, only 11.5% of average-risk individuals eligible for screening after May 2021 received screening before they turned 50," noted Ma. She's a professor of epidemiology at the Yale School of Public Health.

According to the American Cancer Society, about 11% of colorectal cancer cases are now diagnosed in people younger than age 50. That equals about 20,000 people in this age group per year.

In May of 2021, the influential U.S. Preventive Services Task Force dropped the recommended age for first colonoscopy among people at average risk for colon cancer to 45. The American Cancer Society also issued similar guidelines.

The new Yale study, published Oct. 3 in the journal JAMA Network Open, was based on data gleaned from more than 10 million insured Americans aged 45 to 49.

Besides noting the sharp rise in colonoscopy uptake following the 2021 change in recommendations, Ma's team noticed that a person's income and location were key.

“Despite having health insurance, access to cancer screening services strongly depends on where you live,” said study lead author Sunny Siddique, a Ph.D. student at the Yale School of Public Health.

In fact, people residing in a zip code that placed them in the top 20% of U.S. income had a rate of increase in getting a colonoscopy that was 69% higher than folks living in zip codes in the bottom 20% of income, the research showed.

“Residing in a high-income or urban area may enhance your knowledge about colorectal cancer screening or make it easier for you to find a provider," Siddique said in a Yale news release.

Folks living in cities were also 45% more likely to get a colonoscopy compared to people living in rural areas.

So, it's more than simply a person's ability to afford a colonoscopy, Siddique said.

“Health insurance is not enough to reduce disparities,” said Siddique. “We need to selectively help people living in low-income and rural areas receive their recommended screening. Identifying and addressing barriers to screening will be key to reducing these disparities.”

Ma agreed.

“Given the rapid increase in the incidence of colorectal cancer among Americans younger than 50, it is critical to develop and implement initiatives to improve screening for all,” she said.

More information

Find out more about colonoscopy prep at the Cleveland Clinic.

SOURCE: Yale University, news release, Oct. 3, 2024