P0215 - 45 Is the New 50 - Colorectal Screening Guidelines

Raakhi Menon, DO¹, Ayesha Khan, DO¹, Garrett T. Coleman, ², Keegan Colletier, MD¹, Brooke Corning, MD^1
1University of Texas Medical Branch, Galveston, TX; ²University of Texas Medical Branch, John Sealy School of Medicine, Galveston, TX

Introduction: Colorectal cancer (CRC) ranks as the third most common cancer in both men and women in the United States. Notably, while the general incidence of CRC is gradually declining due to increased awareness and screening, there is a rising incidence among individuals under the age of 50. This complex trend has sparked extensive discussions and debates regarding the optimal guidelines for initiating CRC screening.

Methods: We conducted a retrospective analysis of records of average-risk, first-time screening colonoscopies in patients aged 45 to 54 from June 2021 to October 2023 at our institution. Exclusion criteria included pregnant patients, those with a previous history of adenomas, a personal history of inflammatory bowel disease (IBD), a family history of CRC, or a hereditary CRC syndrome. Our primary focus was the Adenoma Detection Rate (ADR) in the 45-49 age group compared to the 50–54-year-old age group at the same institution, as well as to national averages.

Results: Our dataset is comprised of 315 screening colonoscopies in the 45-49 age range and 403 in the 50-54 age range. Our findings revealed an ADR of 32.7% in the 45-49 age group and an ADR of 47.4% in the 50-54 age group.

Notably, the 45-49 age group's ADR of 32.7% exceeded the national average ADR for both the 45-49 (28.6%) and 50-54 (31.8%) age groups. We compared our results to a national study which included 2,806,539 screening colonoscopies conducted by 814 endoscopists. Among the 45-49 age group in our data, males had an average ADR of 34.29%, whereas females had an average ADR of 31.43%. In the 50-54 age group, males had an average ADR of 50%, whereas females had an average ADR of 44.98%. Additionally, non-Hispanic/Latinos in the 45-49 age range exhibited an ADR of 31.28%, while Hispanic/Latinos had an ADR of 33.33%.

Discussion: Our study investigated lowering the CRC screening age from 50 to 45 in average-risk individuals, focusing on prevention and early intervention. It ultimately shows that the ADR in the 45-49 age group surpasses the national average. This may be due to academic gastroenterologists spending more time on colonoscopies and factors like diet, obesity, and environmental exposures. In diverse regions like Southeast Texas, healthcare disparities may contribute to higher ADRs. Our findings support starting CRC screening at age 45, promising advances in patient care and public health by identifying high-risk populations, aiding early CRC detection, and promoting healthcare equity.


Disclosures:


Raakhi Menon, DO¹, Ayesha Khan, DO¹, Garrett T. Coleman, ², Keegan Colletier, MD¹, Brooke Corning, MD¹. P0215 - 45 Is the New 50 - Colorectal Screening Guidelines, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.