# Early Detection and Quality Indicators: Assessing the Clinical Impact and Effectiveness of Lowering the Colorectal Cancer Screening Age

## TL;DR

This study shows that lowering the colorectal cancer screening age to 45 does not reduce detection rates, supporting early screening for better outcomes.

## Contribution

The study provides empirical evidence that the adenoma detection rate remains consistent when lowering the CRC screening age to 45.

## Key findings

- Adenoma detection rates in the 45-49 age group were comparable to those in older age groups.
- Male patients had higher adenoma detection rates across all age groups.
- Polyp biopsy and removal rates were similar between younger and older age groups.

## Abstract

Objective

With colorectal cancer (CRC) being a leading cause of cancer-related deaths globally, early detection through screening is critical for improving survival rates. Recent guidelines recommend lowering the initial screening age from 50 to 45 years based on increasing CRC incidence among younger adults.

Methodology

This retrospective study evaluates the impact of this adjustment on adenoma detection rates (ADR), a validated quality indicator of screening colonoscopies. We conducted a retrospective analysis of 2,792 patients who underwent colonoscopy screening at a major healthcare institution. Patients were categorized into three age groups: 45-49, 50-59, and 60-75 years. We compared ADR across these groups with a focus on evaluating the consistency of ADR in the newly included younger age group against established benchmarks.

Result

The ADRs for the 45-49 age group were 51.2% (105/205) in male patients and 38.5% (116/301) in female patients, closely mirroring those of the 50-59 age group at 51.08% (188/368) in male patients and 34.80% (133/382) in female patients, with no significant reduction in detection rates. Gender-specific analysis revealed higher ADR in male patients across all age groups. These findings were statistically significant when comparing procedure type with age group and gender (p < 0.05).

Conclusion

The study supports maintaining the already established ADR for the new age group of 45-49 as the ADR was comparable to those in the older groups. Similar polyp biopsy +/- removal rates in the 45-49-year-old age group (43.6%; 221/506) compared to the older age group (42.7%; 320/750) is also an indirect measure of the effectiveness of early screening for colon cancer.