As colorectal cancer cases continue to grow in young patients nationwide, screening these patients continues to face setbacks.
One major setback in CRC screening was the COVID-19 pandemic. Two small batch studies from the Indiana University School of Medicine in Indianapolis looked at the impact COVID-19 had on screening and diagnostic colonoscopies in the state.
“The effect of the pandemic on colorectal cancer screening, especially colonoscopies, was profound at two multi-facility healthcare systems in central Indiana over a 30-month period prior to and during the first 18 months of COVID-19. There were literally no screening colonoscopies performed during April of 2020, reflecting the illiquid nature of screening and the acuity of the pandemic which dictated the need for the apportioning of resources to other healthcare needs but this rebounded within a few months,” Thomas Imperiale, MD, senior study author and researcher at the Regenstrief Institute and the IU School of Medicine, said in a March 26 news release from the institute. “Noninvasive testing done at home declined as well but rebounded faster – both fecal immunochemical tests and FIT/DNA tests.”
From January 2019 to June 2021, overall colonoscopy volume declined by about 19%. Despite high survival rates among patients who regularly undergo screenings, approximately 38% of Americans older than 45 have not had a colonoscopy, despite 45 being the new recommended screening age.
The American Cancer Society estimates that CRC will cause about 52,900 deaths in the U.S. in 2025, but the disease is very treatable if caught early.
“The main thing is getting people some screening of any kind. It’s been a hard sell, which is strange considering the statistics,” Peter Senatore, MD, a colon and rectal surgeon at Inspira Health in Vineland, N.J., told Becker’s. “We know this cancer is completely preventable if we do screening and catch it, but it’s hard to understand why people aren’t. Some might be economic, some might be education. We’ve been working with the state, with the [New Jersey Cancer Education and Early Detection] program, trying to do what we can.”
In addition, CRC rates are on the rise among young patients. Early stage research has found that colorectal cancer rates have risen between 45% and 500% for people too young for routine screenings.
A 2024 study found that in people ages 20-24, GI cancer cases increased by 185% from 0.7 100,000 people to 2 per 100,000 over 1999 and 2000. For people older than 25, the increases were smaller, with those ages 40-44 seeing the smallest increase of 45% (from 15 cases per 100,000 people to about 21 per 100,000).
“When I talk to people and give lectures, colon cancer is one of the most common cancers and is the second leading cause of cancer death, and it’s still puzzling to me why it’s that much of a problem we know the vast majority begins with beginning polyps and there’s a significant lead time between finding a polyp and having cancer develop — like 10 years,” Dr. Senatore said. “It should receive more attention, and the real reason is a lot of people aren’t getting any type of screening. And now when you talk about rising rates in younger people, it’s even more important to push people to get some screening and not ignore symptoms.”
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