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Lowering Screening Age Boosts Early Colorectal Cancer Detections in 45–49 Age Group

Default mailed FIT kits now drive screening participation above one-third among 45–49-year-olds, revealing disparities by education and insurance status.

Whether someone is recommended for screening or not, they should still watch for signs and symptoms of colorectal cancer and talk with their doctor if they notice any problems.
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Overview

  • Screening among adults aged 45–49 rose from about 20% in 2019 to 33.7% in 2023 without any drop in older-adult access.
  • Local-stage colorectal cancer incidence in the 45–49 cohort jumped 50% from 9.4 cases per 100,000 in 2019 to 17.5 per 100,000 in 2022, driven by first-time screenings.
  • A randomized trial published in JAMA found unsolicited mailed FIT kits achieved a 26.2% uptake compared with 14.5%–17.4% for active-choice outreach strategies.
  • Increases in screening have been concentrated among highly educated and insured individuals, raising warnings about widening health disparities.
  • Researchers emphasize the need for implementation studies to assess long-term mortality impacts and to optimize outreach for under‐served populations.