Initiating CRC screening at 45 added 20+ life years, decreased CRC incidence, model says

Using a noninvasive test to screen for colorectal cancer when a patient turned 45 years old added life years and decreased CRC incidence compared to starting screening when a patient turned 50 years old, according to a poster presented at ACG 2020, Oct. 23-28.

Researchers used a microsimulation model to see possible outcomes of lowering the CRC screening initiation age. Researchers used the model to see how screening 45-year-old patients with a multitarget stool DNA test every three years or a fecal immunochemical test every year could affect CRC incidence, mortality and life-years gained. Researchers modeled scenarios using reported adherence rates of 71 percent for mt-sDNA and 43 percent for FIT or at perfect adherence for both.

What they found:

1. Screening patients at 45 years added 23.9 life-years gained for mt-sDNA and 24.4 for FIT.

2. Using reported adherence rates, CRC incidence dropped by 64.5 percent at 45 years and 61.1 percent at 50 years using mt-sDNA compared to no screening. CRC incidence also dropped by 53.7 percent at 45 years and 49.9 percent at 50 years using FIT.

3. CRC mortality rates also dropped for both tests. Rates dropped by 71.7 percent at 45 years and 68.7 percent at 50 years for mt-sDNA and 62.7 percent at 45 years and 59 percent at 50 years for FIT.

Researchers concluded: "Non-invasive stool-based screening tests may serve as effective early screening tools among younger populations. LYG and reductions in CRC incidence and mortality are greater when beginning screening at age 45 vs age 50, with gains applying to both pre-Medicare and Medicare populations. CRC outcomes were improved with a lower initiation age for both reported and perfect adherence model assumptions."

ACG denoted the poster as a newsworthy abstract. It was one of 18 posters to receive the honor.

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