More US Adults in Their 40s Undergoing CRC Screening After Age Threshold Lowered: Daily Dose

Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On August 5, 2025, we reported on a study published in JAMA that examined changes in colorectal cancer (CRC) screening uptake among adults aged 45-49 years between 2019 (before the American Cancer Society and US Preventive Services Task Force [USPSTF] lowered the recommended starting age) and 2023.

The study

The study employed a cross-sectional trend analysis using data from the National Health Interview Survey. The researchers estimated the prevalence of being up-to-date (UTD) with CRC screening according to the 2021 USPSTF guidelines, which encompass various screening methods such as fecal occult blood tests, stool DNA testing, colonoscopy, computed tomographic colonography, and sigmoidoscopy, scheduled at specified intervals. To differentiate routine screening from other indications like follow-up procedures, a sensitivity analysis was conducted focusing solely on routine CRC screening.

Logistic regression models were used to estimate adjusted prevalence ratios (APRs) comparing screening uptake from 2019 to 2023 within different age groups. These models adjusted for demographic variables including age, sex, race and ethnicity, education, and region to account for potential confounders.

The findings

• UTD CRC screening prevalence among individuals aged 45 to 49 years increased from 20.8% in 2019 and 19.7% in 2021 to 33.7% in 2023.

• Colonoscopy prevalence increased from 19.5% in 2019 and 17.8% in 2021 to 27.7% in 2023, while stool-based testing increased from 1.3% in 2019 and 2.7% in 2021 to 7.1% in 2023.

• Screening rates remained mostly stable for other age groups.

Authors' comments

"Future research could assess uptake in screening vs nonscreening colonoscopies in representative datasets that can accurately distinguish procedure indication."

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