A new study led by Winship researcher Young-Rock Hong, PhD, MPH, finds colorectal cancer screening rates rose among adults aged 45 to 49 after the U.S. Preventive Services Task Force lowered the recommended screening age from 50 to 45 in 2021.
Young-Rock Hong, PhD, MPH
A new study led by Young-Rock Hong, PhD, MPH, researcher in the Cancer Prevention and Control Program at Winship Cancer Institute of Emory University, shows a significant increase in colorectal cancer screening rates among adults aged 45 to 49 following the 2021 guideline change by the U.S. Preventive Services Task Force that lowered the recommended screening age from 50 to 45 for average-risk individuals.
The analysis, published in Gastroenterology, used nationally representative data from the National Health Interview Survey to compare screening rates in 2019 (before the screening age range was expanded) with rates in 2023 (post-expansion). Screening among the newly eligible 45–49 age group rose from 24.8% in 2019 to 38.7% in 2023—a 14% increase. Health professionals were significantly more likely to recommend screening, with reported recommendations rising from 3.8% to 13.8%.
“Lowering the screening age opened the door to preventive care for nearly 20 million additional Americans,” says Hong, assistant professor in the Department of Family and Preventive Medicine and researcher at Emory University School of Medicine. “Our findings indicate that this change had a measurable impact on clinical practice and patient behavior in a relatively short time.”
The study found the greatest increases in colonoscopies and other endoscopic procedures, while uptake of stool-based and less invasive options remained low. Despite the overall gains, the researchers identified ongoing disparities based on education level and access to care, emphasizing the need for targeted outreach and promotion of non-invasive testing options.
“This increase in screening could have a significant impact on public health by catching more colorectal cancers at an earlier, more treatable stage,” says Hong. “Expanding screening access and awareness among younger adults is a key step in reversing the rise in early-onset colorectal cancer.”
Looking ahead, the research team hopes future implementation will focus on increasing equitable access to all screening options, particularly stool-based testing, which may offer a more accessible and acceptable option for many younger adults. They also call for expanded clinician education and patient outreach to ensure the updated guidelines translate into lifesaving screenings for all eligible individuals.
Co-authors include Rachel Liu-Galvin, MBChB, of the University of Florida, and Zhigang Xie, PhD, BMed, MPA, of the University of North Florida. The study, conducted without external funding, underscores the importance of clinician engagement and responsive health systems in applying national screening guidelines.