Maanek Sehgal1, Uri Ladabaum2, Alka Mithal3, Harminder Singh4, Manisha Desai5, Gurkirpal Singh6. 1. University of California, Los Angeles, California. 2. Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Stanford, California. Electronic address: uri.ladabaum@stanford.edu. 3. Institute of Clinical Outcomes Research and Education, Woodside, California. 4. Section of Gastroenterology, University of Manitoba, Winnipeg, Canada. 5. Division of Bioinformatics Research, Department of Medicine, Stanford University School of Medicine, Stanford, California. 6. Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Stanford, California; Institute of Clinical Outcomes Research and Education, Woodside, California.
Abstract
BACKGROUND & AIMS: Colorectal cancer (CRC) incidence at ages younger than 50 years is increasing, leading to proposals to lower the CRC screening initiation age to 45 years. Data on the effectiveness of CRC screening at ages 45-49 years are lacking. METHODS: We studied the association between undergoing colonoscopy at ages 45-49 or 50-54 years and CRC incidence in a retrospective population-based cohort study using Florida's linked Healthcare Cost and Utilization Project databases with mandated reporting from 2005 to 2017 and Cox models extended for time-varying exposure. RESULTS: Among 195,600 persons with and 2.6 million without exposure to colonoscopy at ages 45-49 years, 276 and 4844 developed CRC, resulting in CRC incidence rates of 20.8 (95% CI, 18.5-23.4) and 30.6 (95% CI, 29.8-31.5) per 100,000 person-years, respectively. Among 660,248 persons with and 2.4 million without exposure to colonoscopy at ages 50-54 years, 798 and 6757 developed CRC, resulting in CRC incidence rates of 19.0 (95% CI, 17.7-20.4) and 51.9 (95% CI, 50.7-53.1) per 100,000 person-years, respectively. The adjusted hazard ratios for incident CRC after undergoing compared with not undergoing colonoscopy were 0.50 (95% CI, 0.44-0.56) at ages 45-49 years and 0.32 (95% CI, 0.29-0.34) at ages 50-54 years. The results were similar for women and men (hazard ratio, 0.48; 95% CI, 0.40-0.57 and hazard ratio, 0.52; 95% CI, 0.43-0.62 at ages 45-49 years, and hazard ratio, 0.35; 95% CI, 0.31-0.39 and hazard ratio, 0.29; 95% CI, 0.26-0.32 at ages 50-54 years, respectively). CONCLUSIONS: Colonoscopy at ages 45-49 or 50-54 years was associated with substantial decreases in subsequent CRC incidence. These findings can inform screening guidelines.
BACKGROUND & AIMS:Colorectal cancer (CRC) incidence at ages younger than 50 years is increasing, leading to proposals to lower the CRC screening initiation age to 45 years. Data on the effectiveness of CRC screening at ages 45-49 years are lacking. METHODS: We studied the association between undergoing colonoscopy at ages 45-49 or 50-54 years and CRC incidence in a retrospective population-based cohort study using Florida's linked Healthcare Cost and Utilization Project databases with mandated reporting from 2005 to 2017 and Cox models extended for time-varying exposure. RESULTS: Among 195,600 persons with and 2.6 million without exposure to colonoscopy at ages 45-49 years, 276 and 4844 developed CRC, resulting in CRC incidence rates of 20.8 (95% CI, 18.5-23.4) and 30.6 (95% CI, 29.8-31.5) per 100,000 person-years, respectively. Among 660,248 persons with and 2.4 million without exposure to colonoscopy at ages 50-54 years, 798 and 6757 developed CRC, resulting in CRC incidence rates of 19.0 (95% CI, 17.7-20.4) and 51.9 (95% CI, 50.7-53.1) per 100,000 person-years, respectively. The adjusted hazard ratios for incident CRC after undergoing compared with not undergoing colonoscopy were 0.50 (95% CI, 0.44-0.56) at ages 45-49 years and 0.32 (95% CI, 0.29-0.34) at ages 50-54 years. The results were similar for women and men (hazard ratio, 0.48; 95% CI, 0.40-0.57 and hazard ratio, 0.52; 95% CI, 0.43-0.62 at ages 45-49 years, and hazard ratio, 0.35; 95% CI, 0.31-0.39 and hazard ratio, 0.29; 95% CI, 0.26-0.32 at ages 50-54 years, respectively). CONCLUSIONS: Colonoscopy at ages 45-49 or 50-54 years was associated with substantial decreases in subsequent CRC incidence. These findings can inform screening guidelines.
Authors: Charles R Rogers; Roger Figueroa; Ellen Brooks; Ethan M Petersen; Carson D Kennedy; Darrell M Gray Ii; Michael Sapienza; Man Hung Journal: Am J Cancer Res Date: 2021-12-15 Impact factor: 6.166
Authors: Caroline Himbert; Jane C Figueiredo; David Shibata; Jennifer Ose; Tengda Lin; Lyen C Huang; Anita R Peoples; Courtney L Scaife; Bartley Pickron; Laura Lambert; Jessica N Cohan; Mary Bronner; Seth Felder; Julian Sanchez; Sophie Dessureault; Domenico Coppola; David M Hoffman; Yosef F Nasseri; Robert W Decker; Karen Zaghiyan; Zuri A Murrell; Andrew Hendifar; Jun Gong; Eiman Firoozmand; Alexandra Gangi; Beth A Moore; Kyle G Cologne; Maryliza S El-Masry; Nathan Hinkle; Justin Monroe; Matthew Mutch; Cory Bernadt; Deyali Chatterjee; Mika Sinanan; Stacey A Cohen; Ulrike Wallin; William M Grady; Paul D Lampe; Deepti Reddi; Mukta Krane; Alessandro Fichera; Ravi Moonka; Esther Herpel; Peter Schirmacher; Matthias Kloor; Magnus von Knebel-Doeberitz; Johanna Nattenmueller; Hans-Ulrich Kauczor; Eric Swanson; Jolanta Jedrzkiewicz; Stephanie L Schmit; Biljana Gigic; Alexis B Ulrich; Adetunji T Toriola; Erin M Siegel; Christopher I Li; Cornelia M Ulrich; Sheetal Hardikar Journal: Cancers (Basel) Date: 2021-07-29 Impact factor: 6.575