Insights from age-stratified endoscopic detection metrics support initiating colorectal cancer screening at age 45

All major U.S. guidelines now validate average-risk colorectal cancer (CRC) screening at 45-49 years of age. We aimed to highlight the importance of promoting colonoscopy among younger populations as part of a comprehensive strategy to reduce the burden of CRC. Our study analyzed data from 235,782 colonoscopy reports of individuals, which were categorized into six age groups: 45-49 years, 50-54 years, 55-59 years, 60-64 years, 65-69 years, and 70-74 years. Parameters such as age, gender, histopathology of polyps, quantity of polyps, and polyp detection rate (PDR) were assessed. Our study shows a progressive increase in colonoscopy uptake among individuals aged 45-54. PDR increased significantly with age, from 25.7% in the 45-49 group to 40.2% in the 70-74 group (p < 0.05). Notably, the PDR difference between the 45-49 and 50-54 groups was not statistically significant (25.7% vs. 26.8%, p = ns), indicating comparable polyp burden. Carcinoma detection rates followed a similar pattern, with no significant difference between the 45-49 (0.29%) and 50-54 (0.29%) groups, while a substantial rise occurred from age 55 onwards (p < 0.05). Individuals screened in the 45-49 age group exhibited comparable PDR and carcinoma detection rates to those in the 50-54 age range.