Colorectal cancer screening rates more than doubled among people under the age of 50 after the release of updated American Cancer Society guidelines that recommended screening for particular age groups.

Testing for the disease rose among individuals between the ages of 45 and 49 following the May 2018 release of the updated guidelines, which lowered the age to begin average-risk screening from 50 to 45 years of age. The change in the recommended age stemmed from increasing incidence of early onset colorectal cancer and a favorable benefit-to-harm ratio.

Researchers examined recent CRC screening patterns among adults between 45 and 49, and compared them to those of adults, age 50-59, in the U.S. Their assessment was based on responses in the 2018 National Health Interview Survey (NHIS), an in-person household survey issued to 5,800 people between 45 and 59.

Results showed an increase of past-year CRC screening rates from 4.8 percent in the first quarter of 2018 to 6.6 percent in the second quarter, 8.8 percent in the third, and 11.7 percent in the fourth. Screening rates were 4.1 percent and seven percent higher in the third and fourth quarters, respectively, compared to the first quarter. The estimated number of 45 to 49-year-olds who got tested rose from 226,656 in Q1 to 592,351, a difference of 365,695. Past-year CRC screening did not increase among people in their 50s.

The researchers note that the 2018 ACS guidelines, and the combination of supporting scientific evidence and media attention may have brought greater awareness to patients and providers of asymptomatic and symptomatic testing for CRC. They point out that similar abrupt changes in screening following the release of updated guidelines have also been seen for prostate and breast cancer, as well as in the short term in CRC screening following media campaigns.

“It is unknown whether the recent accelerating CRC screening rates among people 45-49 years will be sustained,” said Dr. Stacey Fedewa, the senior principal scientist in the surveillance and health services research department at the ACS and the lead investigator in the study, in a statement. “Commercial health insurers are only required to cover average-risk screening beginning at age 50, following recommendations from the U.S. Preventive Services Task Force. Also, it’s possible those who quickly adopted updated guidelines may have been those at increased risk.”

The findings were published in the journal, CANCER.

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