New CRC Screening Guidelines Lead to Near 10-Fold Uptake for Adults Aged 45 to 49 Years: Daily Dose

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On November 5, 2025, we reported on a study published in JAMA Network Open that was designed to examine the impact of guideline changes to colorectal cancer (CRC) screening.

The study

Researchers conducted a cohort study that evaluated colorectal cancer (CRC) screening encounters using the Vizient Clinical Data Base, which collects administrative data from over 1350 US hospitals. The study identified CRC screening encounters among individuals aged 45 to 75 years between January 2016 and December 2024. The researchers established 3 distinct study periods—prechange (January 2016 to May 2018), interim (June 2018 to May 2021), and postchange (June 2021 to December 2023)—to align with American Cancer Society (ACS) and US Preventive Services Task Force (USPSTF) guideline updates. The primary outcomes were the proportion of screenings performed on 45- to 49-year-olds among all screenings in the 45- to 75-year-old group and the change in monthly screening volume. Secondary outcomes included sociodemographic screening patterns, such as race, ethnicity, and socioeconomic vulnerability, which was assessed using the Vizient Vulnerability Index based on zip code-level factors like income and health care access.

The findings

The proportion of screenings involving individuals aged 45 to 49 years rose from 2.9% in the prechange period (January 2016 to May 2018) to 17.8% in the postchange period (June 2021 to December 2023), according to the results.

Mean monthly screening volume in the 45- to 49-year age group increased 948%, from 1578 in the prechange period to 16 534 in the postchange period. By comparison, screening monthly volume among those aged 50 to 75 years increased 46% during the same timeframe, from 52 348 pre-change to 76 503 post-change.

Compared with the prechange period, the postchange period showed statistically significant differences across race, ethnicity, payer, and vulnerability groups. Non-Hispanic Black representation decreased by 4.1 percentage points, Medicare enrollees decreased by 2.3 percentage points, and individuals from high-vulnerability neighborhoods decreased by 1.6 percentage points. Hispanic representation increased by 7.4 percentage points.

Authors' comments

"These findings reflect CRC screening in hospitals, where guideline adoption is critical to shaping clinical practice and building momentum toward broader public health impact. Continued efforts to sustain this momentum may help optimize uptake. Although opportunities remain to address disparities and investigate at-home screening, this highlights the early success of facility-based guideline implementation."

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