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Colonoscopy Alert: Young Adults May Need Screening Sooner than Expected

Written by Andrew Le, MD

UpdatedApril 26, 2024

New Colonoscopy Findings for 45- to 49-Year-Olds—What You Should Know

For individuals in the 45 to 49 age group, colorectal cancer screening is increasingly coming under the spotlight. A systematic review and meta-analysis have uncovered valuable insights into the occurrence of pre-cancerous lesions within this demographic. The findings shed light on the impact that beginning screening at an earlier age may have.

The Study: A Closer Look at Detection Rates

Led by a team of experts, including Mohamed Abdallah, MD, and Aasma Shaukat, MD, MPH, the review assessed the rate of adenomas detection (ADR) and sessile serrated lesions (SSLs) in 45- to 49-year-olds undergoing colonoscopies. These findings play a pivotal role as ADR serves as a key quality indicator for colonoscopy, which can influence colorectal cancer screening guidelines and practices.

The comprehensive investigation analyzed records from databases including MEDLINE and EMBASE through October 2022. The findings were substantial, drawing from 16 retrospective studies, except for one, which included national and local registries. With 150,436 colonoscopies recorded, the researchers determined a pooled overall ADR of 23.1% and an SSL detection rate of 6.3%.

What This Means for Early Screening

These percentages are notable since they align with ADRs in the 50–54 demographic, evidencing that beginning screening at 45 could be just as critical. Furthermore, the ADR for individuals at average risk undergoing screening colonoscopy was 28.2%, reinforcing the recommended early screening age. However, the study acknowledged a higher ADR and SSL detection rate in studies from the United States compared to those from Asia, highlighting possible geographic variances in colonoscopy outcomes.

Impact on Future Screening Guidelines

The study results are timely and influence the conversation about the optimal age to start colon cancer screenings. As colorectal cancer is the second leading cause of cancer-related deaths in the United States but is preventable through early detection, these findings are crucial.

Quality Assessment and Limitations

While the studies utilized were of moderate to high quality and included considerable sample sizes, the researchers noted that the high heterogeneity among studies might limit the generalizability of the findings.

In Conclusion

This meticulous study significantly contributes to the ongoing discussion regarding the benefits of early colon cancer screening starting at the age of 45. It concludes that individuals in the 45–49 age bracket do indeed have comparable rates of pre-cancerous lesions to those a bit older. These findings could influence future screening guidelines and emphasize the importance of vigilance in early screening practices.

Read the study in its entirety at Am J Gastroenterol 2024, and for further resources, visit This research article endorses the significance of colorectal cancer screening as a lifesaving measure.

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Abdallah, M., Mohamed, M. F. H., Abdalla, A. O., Jaber, F., Baliss, M., Ahmed, K., Eckmann, J., Bilal, M., & Shaukat, A. (2024). Adenomas and sessile serrated lesions in 45- to 49-year-old individuals undergoing colonoscopy: A systematic review and meta-analysis. The American Journal of Gastroenterology, 00(1), 1-7.