Surveillance & Health Equity Science Research, American Cancer Society, Atlanta, GA, USA.
American Cancer Society Center for Cancer Screening and Early Cancer Detection Research, Atlanta, GA, USA.
J Natl Cancer Inst. 2024 Apr 5;116(4):613-617. doi: 10.1093/jnci/djae003.
Several organizations now recommend that individuals at average risk for colorectal cancer (CRC) begin screening at 45 rather than 50 years of age. We present contemporary estimates of CRC screening in newly eligible adults aged 45 to 49 years between 2019 and 2021. Nationally representative prevalence estimates and population number screened were estimated based on the National Health Interview Survey. A logistic regression model assessed CRC screening prevalence differences by survey year and sociodemographic characteristics. In 2021, 19.7%-that is, fewer than 4 million of the eligible 19 million adults aged 45 to 49 years-were up-to-date on CRC screening. Screening was lowest in those who were uninsured (7.6%), had less than a high school diploma (15.4%), and Asian (13.1%). Additionally, fecal occult blood test and/or fecal immunochemical testing was underused, with only 2.4% (<460 000 people) reporting being up-to-date with screening using this modality in 2021. CRC screening in eligible young adults remains low. Concerted efforts to improve screening are warranted, particularly in underserved populations.
现在有几个组织建议,有结直肠癌(CRC)平均风险的个人应在 45 岁而不是 50 岁开始筛查。我们提供了 2019 年至 2021 年期间新符合条件的 45 至 49 岁成年人中 CRC 筛查的当代估计值。基于全国健康访谈调查,我们估计了全国代表性的筛查患病率估计值和筛查人数。逻辑回归模型评估了调查年份和社会人口统计学特征对 CRC 筛查流行率差异的影响。2021 年,符合条件的 1900 万 45 至 49 岁成年人中,只有 19.7%(即不到 400 万人)接受了 CRC 筛查。未参保者(7.6%)、未完成高中学业者(15.4%)和亚裔(13.1%)的筛查率最低。此外,粪便潜血试验和/或粪便免疫化学检测的使用率较低,2021 年只有 2.4%(<46 万人)报告使用这种方式接受了最新的筛查。符合条件的年轻成年人的 CRC 筛查率仍然较低。需要做出协调一致的努力来提高筛查率,特别是在服务不足的人群中。