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yesterday

Mailed FIT Outreach Spurs Screening Rise and Early-Stage Colorectal Cancer Detection in 45–49 Year Olds

Recent JAMA publications demonstrate that default mailed FIT kits outperform active-choice outreach, revealing persistent screening gaps among uninsured and less-educated populations.

Colon cancer microscopic photography, magnification x400
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

  • The American Cancer Society in 2018 and USPSTF in 2021 lowered the average-risk colorectal cancer screening age from 50 to 45, expanding eligibility to roughly 20 million more adults.
  • Up-to-date screening among 45–49 year olds climbed from 20.8% in 2019 to 33.7% in 2023 while rates for those aged 50–75 remained stable, dispelling concerns of resource diversion.
  • SEER registry data show local-stage colorectal cancer diagnoses in 45–49 year olds surged by 50% between 2021 and 2022, driven largely by first-time screenings.
  • A randomized JAMA trial found unsolicited mailed fecal immunochemical test kits achieved a 26.2% completion rate, significantly outpacing the 14.5–17.4% uptake in active-choice outreach groups.
  • Screening increases have been minimal among uninsured individuals and those without a high school diploma, underscoring the need for equitable implementation and continued monitoring of mortality outcomes.