Younger Eligible Adults Are Less Likely to Meet Recommended Colorectal Cancer Guidelines

Screening participation increased over time, but the increase was smallest among individuals aged 50 to 54.

Younger adults in the United States are less likely to be screened for colorectal cancer than older adults, despite now being eligible under updated guidelines, according to new research. Furthermore, younger adults also face greater disparities than older adults who are eligible for screenings.

In 2018, investigators found that adults between 50 and 54 years of age were 30.4% less likely to be screened for colorectal cancer than those between 70 and 75 years of age. Younger adults also faced more disparities based on race, ethnicity, household income, educational attainment, and insurance coverage, according to the study.

The findings come one year after the US Preventive Services Task Force updated its guidelines for colorectal cancer screenings, lowering the recommended age of first screening from 50 to 45 years for adults with an average risk of the disease.

“We wanted to be able to anticipate what to expect in terms of screening disparities among that younger age group of 45- to 49-year-olds based on what we’re seeing in the previous youngest age group of 50- to 54-year-olds,” said lead researcher Caitlin Murphy, PhD, MPH, in a press release. “Just because the recommended age has been lowered doesn’t mean more people will be getting screened for colorectal cancer.”

Investigators used data from the National Health Interview Survey. Colorectal cancer screening participation was assessed among 80,000 adults in the United States between 50 and 75 years of age with no history of colorectal cancer during 8 discontinuous years between 2000 and 2018.

The analysis found that screening participation increased over time, but the increase was smallest among individuals 50 to 54 years of age, which grew from 28.8% in the year 2000 to 47.6% in the year 2018. In contrast, screenings for individuals between 70 and 75 years of age rose from 46.4% in the year 2000 to 78% in the year 2018.

In 2018, researchers also observed larger screening disparities by race and ethnicity, education level, household income, and health insurance coverage among individuals 50 to 54 years of age compared with individuals 70 to 75 years of age. Notably, Hispanic individuals had 15.5% lower screening rates than non-Hispanic white individuals between 50 and 54 years of age, but the difference was just 0.3% for those 70 to 75 years of age. For Asian individuals, screening was 17.7% lower than non-Hispanic white individuals 50 to 54 years of age but was 9.4% lower for those aged 70 to 75.

For individuals with less than a high school diploma, screening was 24% lower than for individuals with a bachelor’s degree or higher in the group between 50 and 54 years of age. However, it was 13.9% lower for those 70 to 75 years of age. Similarly, screening for uninsured individuals was 43.4% lower than for individuals receiving military insurance between of 50 and 54 years of age but was 1.2% lower for those 70 to 75 years of age.

Although additional research is needed to determine what barriers individuals 45 to 49 years of age might face, Murphy said these disparities may worsen among the lower age group. She also called for more efforts to increase screening for younger individuals.

“Considering the various demands placed on people in their late 40s, from caregiving responsibilities to increased workloads, they may have even more barriers to getting screened,” Murphy said in the press release. “I hope this encourages us to think about new ways we can address the unique needs of this younger population as these guidelines are implemented.”

REFERENCE

Eligible younger US adults less likely to meet recommended colorectal cancer screening guidelines and face greater disparities. News release. UT Health Houston; June 29, 2022. Accessed July 1, 2022. https://www.uth.edu/news/story/eligible-younger-us-adults-less-likely-to-meet-recommended-colorectal-cancer-screening-guidelines-and-face-greater-disparities