March is Colorectal Cancer (CRC) Awareness Month and we’re spotlighting strategies that can help bolster screening rates. In recent years, CRC rates have increased in people under 50 years old, emphasizing the importance of early detection. Recognizing this, the U.S. Preventive Services Task Force lowered the recommended screening age from 50 to 45 in 2021. Participation among this newly eligible age group has remained low, with fewer than 2% getting screened within the first 20 months after the guideline change.
What are some ways to encourage more screening? A new study offers more insights.
Colonoscopy vs. stool-based tests
Researchers at UCLA Health tested four strategies to encourage adults ages 45 to 49 to get screened for CRC, including mailing stool-based tests (FIT kits) and offering colonoscopies. The study included more than 20,000 patients considered at average risk, making it one of the first large-scale efforts to understand how best to reach this age group.
Here’s what they tested:
- Asking patients if they wanted to opt into screening by receiving a mailed FIT kit.
- Asking patients if they wanted to opt into a colonoscopy.
- Asking patients if they wanted to opt into screening and choose between a FIT kit or a colonoscopy.
- Simply mailing a FIT kit directly to patients without requiring any action to opt in.
What the results showed
The results were striking: when patients had to actively opt in or make a choice, only about 15–17% completed screening. When the FIT kit was mailed automatically to their home, over 26% got screened.
Dr. Folasade May, a gastroenterologist and cancer prevention researcher at UCLA Health, explained, “Removing the need for patients to actively opt into screening can lead to better outcomes, particularly when trying to engage younger, generally healthy adults who may not yet perceive themselves at risk for cancer.”
The study also showed that follow-up care works: 73% of people with an abnormal FIT result completed a colonoscopy within six months, which is considered the “gold standard” in CRC screening. While overall screening rates are still lower than researchers hope, this approach is a simple, low-cost intervention that can reach more people. In just six months, more than 3,800 patients were screened.
Why screening matters
CRC often develops without noticeable symptoms, making early detection difficult if you’re feeling healthy otherwise. Screening is critical because it can not only catch CRC early, but also identify precancerous polyps before they turn into cancer.
This study highlights a key takeaway: A simple screening process helps increase participation. By removing barriers, more people complete screening. For this CRC Awareness Month, talk to your doctor about screening and encourage your loved ones to do the same.
Want to learn more about CRC? Watch our full webinar episode with MD Anderson Cancer Center’s Dr. Scott Kopetz for more information.
