ACS finds colon cancer screening in 40s on the rise

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Colon cancer screening among average-risk adults between the ages of 45 and 49 has been on the rise: It more than doubled in 2018, according to in-person survey data for 5,800 people reported by the American Cancer Society (ACS) on December 18 in Cancer.

The ACS studied self-reports of colon cancer screening with a range of methods -- colonoscopy, sigmoidoscopy, computed tomography (CT) colonography, or stool testing -- using data from the 2018 National Health Interview Survey. In May 2018, the ACS updated its guidance to recommend that colon cancer screening begin at age 45 rather than 50 in adults with average risk.

Reports of past-year screening for colon cancer among people ages 45 to 49 rose in a linear fashion throughout 2018. In the first quarter, 4.1% reported that they had been screened, compared with 11.7% in the fourth quarter, according to lead author Stacey Fedewa, PhD, senior principal scientist in surveillance and health services research at the ACS, and colleagues. Most of the respondents were privately insured, and half were male. In contrast, rates of self-reported screening for people in their 50s did not change in 2018.

The study didn't evaluate what type of testing was being done, but the ACS noted by email that prior research suggests most in the 45- to 49-year age group receive colonoscopy as a screening method.

Guidelines vary greatly when it comes to colon cancer screening, which has been a source of confusion for the public. The U.S. Preventive Services Task Force (USPSTF) advises that screening begin at age 50 for those with average risk.

"The 2018 ACS guidelines and accompanying scientific and lay media attention may have raised provider and patient awareness of asymptomatic and symptomatic testing for [colorectal cancer (CRC)]. ... However, it is unknown whether the recent accelerating CRC screening rates among people 45-49 years will be sustained as commercial health insurers are only required to cover average-risk screening beginning at 50 years consistent with the U.S. Preventive Services Task Force recommendations," Fedewa and colleagues wrote.

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