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Background and aim <p>All major U.S. guidelines now validate average-risk colorectal cancer (CRC) screening at 45–49 years of age. We aimed to highlight the importance of promoting colonoscopy among younger populations as part of a comprehensive strategy to reduce the burden of CRC.</p> Methods <p>Our study analyzed data from 235,782 colonoscopy reports of individuals, which were categorized into six age groups: 45–49 years, 50–54 years, 55–59 years, 60–64 years, 65–69 years, and 70–74 years. Parameters such as age, gender, histopathology of polyps, quantity of polyps, and polyp detection rate (PDR) were assessed.</p> Results <p>Our study shows a progressive increase in colonoscopy uptake among individuals aged 45–54. PDR increased significantly with age, from 25.7% in the 45–49 group to 40.2% in the 70–74 group (<i>p</i> &lt; 0.05). Notably, the PDR difference between the 45–49 and 50–54 groups was not statistically significant (25.7% vs. 26.8%, p = ns), indicating comparable polyp burden. Carcinoma detection rates followed a similar pattern, with no significant difference between the 45–49 (0.29%) and 50–54 (0.29%) groups, while a substantial rise occurred from age 55 onwards (<i>p</i> &lt; 0.05).</p> Conclusions <p>Individuals screened in the 45–49 age group exhibited comparable PDR and carcinoma detection rates to those in the 50–54 age range.</p>

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Insights from age-stratified endoscopic detection metrics support initiating colorectal cancer screening at age 45

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  • 发表日期：

    2025年8月19日

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  • Majd Khader,
  • Jorge-Shmuel Delgado,
  • Rimon Artoul,
  • Asher Shafrir,
  • Abu-Freha Naim

摘要

Background and aim

All major U.S. guidelines now validate average-risk colorectal cancer (CRC) screening at 45–49 years of age. We aimed to highlight the importance of promoting colonoscopy among younger populations as part of a comprehensive strategy to reduce the burden of CRC.

Methods

Our study analyzed data from 235,782 colonoscopy reports of individuals, which were categorized into six age groups: 45–49 years, 50–54 years, 55–59 years, 60–64 years, 65–69 years, and 70–74 years. Parameters such as age, gender, histopathology of polyps, quantity of polyps, and polyp detection rate (PDR) were assessed.

Results

Our study shows a progressive increase in colonoscopy uptake among individuals aged 45–54. PDR increased significantly with age, from 25.7% in the 45–49 group to 40.2% in the 70–74 group (p < 0.05). Notably, the PDR difference between the 45–49 and 50–54 groups was not statistically significant (25.7% vs. 26.8%, p = ns), indicating comparable polyp burden. Carcinoma detection rates followed a similar pattern, with no significant difference between the 45–49 (0.29%) and 50–54 (0.29%) groups, while a substantial rise occurred from age 55 onwards (p < 0.05).

Conclusions

Individuals screened in the 45–49 age group exhibited comparable PDR and carcinoma detection rates to those in the 50–54 age range.