Self-reported reasons for colonoscopy among adults aged 45-49 versus 50 years and older from 2010-2018 |
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| Affiliation: | 1. Department of Radiation Oncology, University of Texas Southwestern, Dallas, TX, USA;2. Department of Medical Oncology, University of Texas Southwestern, Dallas, TX, USA;3. Division of Biostatistics, Department of Clinical Sciences, University of Texas Southwestern Medical Center, TX, USA;1. Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda;2. Harvard Medical School, Boston, MA, United States;3. Moi University, Eldoret, Kenya;4. Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya;5. University of California, San Francisco, CA, United States;6. Masaka Regional Referral Hospital, Masaka, Uganda;7. Mbarara Regional Referral Hospital, Mbarara, Uganda;8. Indiana University, Indianapolis, IN, United States;1. Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230000, Anhui, China;2. Laboratory for Environmental Toxicology, Anhui Medical University, Hefei 230032, Anhui, China;1. Harvard School of Public Health, Boston, USA;2. Department of Surgery & Cancer, Imperial College London, UK;3. Department of Medicine, Mount Auburn Hospital, Harvard Medical School, Cambridge, USA;4. Oxford University Clinical Academic Graduate School, John Radcliffe Hospital, Oxford, UK;1. Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO, USA;2. Data Analytics Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA;3. Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA;4. Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA;1. Institute for Cancer Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany;2. Danish Cancer Society, Strandboulevarden 49, 2100, København, Denmark;1. Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany;2. Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada;3. Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Italy;4. Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy;5. Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany;6. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria;7. Departments of Urology, Weill Cornell Medical College, New York, NY, USA;8. Department of Urology, University of Texas Southwestern, Dallas, TX, USA;9. Department of Urology, Second Faculty of Medicine, Charles University, Prag, Czech Republic;10. Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia;11. Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan |
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| Abstract: | BackgroundIn May of 2018, the American Cancer Society lowered the age of colorectal cancer (CRC) screening initiation from 50 to 45 years and in October 2020, United States Preventive Services Task Force published draft guidelines also lowering age of screening initiation to 45 years. Evaluating guideline adherence is needed; however, the majority of prior research on cancer screening do not distinguish whether colonoscopy was performed for true screening purposes or for post-symptomatic diagnosis.MethodsUsing data from the National Health Interview Survey between 2010 to mid-2018, we assessed response to the question “What was the MAIN reason you had [last] colonoscopy?” stratified by age (45−49 versus 50+ years). Multivariable logistic regression defined adjusted odds ratios of receiving last colonoscopy for screening controlling for relevant demographic characteristics. To estimate the cost burden of colonoscopy, the proportion of respondents reporting paying out of pocket for their last colonoscopy was assessed.ResultsAmong 29,074 participants who had undergone a colonoscopy, 44.4 % of those aged 45–50 reported routine procedure as the reason for their most recent colonoscopy, as compared to 82.4 % in the 50+ age group (p < 0.001). Characteristics associated with undergoing colonoscopy as a routine procedure included Black race and male sex for both age cohorts (p < 0.01 for all). Notably, almost half (46.9 %) of participants younger than 50 years paid part of or the full cost of their colonoscopy, as compared to 30.7 % over the age of 50 (p < 0.001).ConclusionsThe majority of adults aged 45−49 self-report that last colonoscopy was not performed for screening, which is unsurprising given guidelines for screening for individuals under 50. As guidelines change, continued surveillance of colonoscopy patterns across age cohorts is needed, and studies should also incorporate reasons for testing. |
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| Keywords: | Colorectal cancer Colonoscopy Screening |
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