Retrospective analysis of colorectal cancer incidence in US adults after recommendations for earlier screening

The recommended age to begin colorectal cancer (CRC) screening was lowered from 50 to 45 years by the ACS in 2018 and the USPSTF in 2021. A retrospective analysis of SEER data investigated the CRC incidence among adults younger than 55 years from 2004 to 2022. CRC incidence increased steadily by 1.6% annually since 2004 among adults aged 20 to 39 years. Among adults 45 to 49 years an increase of 1.1% annually during 2004-2019 accelerated tot 12.0% annually during 2019-2022. This steep increase was driven by local-stage tumors, which increased from 9.4 per 100,000 in 2019 to 11.7 per 100,000 in 2021 (relative increase 25%) and to 17.5 per 100,000 in 2022 (50% increase relative to 2021) after stable rates from 2004-2019. The authors conclude that these increases likely reflect diagnosis of prevalent asymptomatic cancer through first-time screening due to recommendations to begin screening at age 45 years instead of 50 years.