New research adds weight to updated U.S. guidelines recommending colorectal cancer (CRC) screening begin at age 45 rather than 50.
In a large analysis of 235,782 colonoscopy reports, investigators assessed polyp and carcinoma detection rates across age groups ranging from 45 to 74 years. The study, published in BMC Gastroenterology, found that individuals aged 45–49 had nearly identical rates of polyp detection (25.7%) and carcinoma detection (0.29%) compared with those aged 50–54 (26.8% and 0.29%, respectively).
Detection rates rose substantially after age 55, but the similarity between the 45–49 and 50–54 groups underscores the importance of earlier screening. “Our findings support colonoscopy beginning at age 45 as a crucial step in reducing the burden of colorectal cancer,” the authors concluded.
The results align with recent shifts in clinical practice, where earlier screening is increasingly emphasized to address rising CRC incidence among younger adults. Encouraging uptake of colonoscopy in the 45–49 age group could lead to earlier polyp removal, improved cancer prevention, and reduced mortality.
Reference
Khader M et al. Insights from age-stratified endoscopic detection metrics support initiating colorectal cancer screening at age 45. BMC Gastroenterol. 2025;DOI: 10.1186/s12876-025-04213-2.
