Low colorectal cancer screening among adults aged 45-49 years in the US, 2023.
Level 4 - case-series / case-control
Cross-sectional survey analysis of nationally representative observational data (NHIS)
PubMed 41886345 · doi:10.37765/ajmc.2026.89902
What was done
Retrospective observational study analyzing all adults aged 45 to 54 years from the 2023 US National Health Interview Survey (NHIS). The rate of colorectal cancer (CRC) screening was compared between adults aged 45 to 49 years and those aged 50 to 54 years. Multivariable logistic regression evaluated the association between age group and CRC screening, controlling for sex, race/ethnicity, immigrant status, college education, insurance status, and a wellness visit within one year. A sensitivity analysis focused on colonoscopy use specifically.
What was found
CRC screening was significantly lower among adults aged 45 to 49 years than among those aged 50 to 54 years (36.1% vs 55.6%; P < .001). The difference persisted in multivariate logistic regression (OR, 0.44; 95% CI, 0.39-0.51). Predictors of screening included US-born status, college education, insurance coverage, and a wellness visit within one year. Sensitivity analysis for colonoscopy confirmed these findings (OR, 0.48; 95% CI, 0.42-0.55).
Why it matters
Despite updated guidelines lowering the recommended CRC screening age to 45, uptake remains substantially lagging in the 45-to-49 age group compared to older adults, with roughly one-third screened.
Limits
The total sample size was not reported in the abstract. Data rely on self-reported survey responses from the NHIS, which are subject to recall and reporting bias rather than medical record verification.
Cited by
- context Only about 20% of eligible adults aged 45 to 49 are actually obtaining screening colonoscopies.