Colorectal Cancer Screening Completion and Yield in Patients Aged 45 to 50 Years : An Observational Study.

Autor:	Levin TR; Division of Research, Kaiser Permanente Northern California, Oakland, California, and Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California (T.R.L.)., Jensen CD; Division of Research, Kaiser Permanente Northern California, Oakland, California (C.D.J., N.U., J.M.B., C.P.Q., J.K.L.)., Udaltsova N; Division of Research, Kaiser Permanente Northern California, Oakland, California (C.D.J., N.U., J.M.B., C.P.Q., J.K.L.)., Burnett-Hartman AA; Kaiser Permanente Colorado, Institute for Health Research, Aurora, Colorado (A.A.B.-H., L.L.W., B.P.H., S.R.G.)., Kamineni A; Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington, Seattle, Washington (A.K., G.P., M.O., S.C.B.)., Chao CR; Kaiser Permanente Bernard J. Tyson School of Medicine, and Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California (C.R.C.)., Schottinger JE; Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California (J.E.S.)., Ghai NR; Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California (N.R.G., H.C.)., Pocobelli G; Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington, Seattle, Washington (A.K., G.P., M.O., S.C.B.)., White LL; Kaiser Permanente Colorado, Institute for Health Research, Aurora, Colorado (A.A.B.-H., L.L.W., B.P.H., S.R.G.)., Oliver M; Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington, Seattle, Washington (A.K., G.P., M.O., S.C.B.)., Chowdhry H; Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California (N.R.G., H.C.)., Hixon BP; Kaiser Permanente Colorado, Institute for Health Research, Aurora, Colorado (A.A.B.-H., L.L.W., B.P.H., S.R.G.)., Badalov JM; Division of Research, Kaiser Permanente Northern California, Oakland, California (C.D.J., N.U., J.M.B., C.P.Q., J.K.L.)., Goldberg SR; Kaiser Permanente Colorado, Institute for Health Research, Aurora, Colorado (A.A.B.-H., L.L.W., B.P.H., S.R.G.)., Bradford SC; Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington, Seattle, Washington (A.K., G.P., M.O., S.C.B.)., Quesenberry CP; Division of Research, Kaiser Permanente Northern California, Oakland, California (C.D.J., N.U., J.M.B., C.P.Q., J.K.L.)., Lee JK; Division of Research, Kaiser Permanente Northern California, Oakland, California (C.D.J., N.U., J.M.B., C.P.Q., J.K.L.).
Jazyk:	angličtina
Zdroj:	Annals of internal medicine [Ann Intern Med] 2024 Dec; Vol. 177 (12), pp. 1621-1629. Date of Electronic Publication: 2024 Oct 22.
DOI:	10.7326/M24-0743
Abstrakt:	Background: Guidelines now recommend initiating colorectal cancer (CRC) screening at age 45 years rather than 50 years, but little is known about screening completion and yield among people aged 45 to 49 years. Objective: To evaluate fecal immunochemical test (FIT) completion and yield in patients aged 45 to 49 versus 50 years. Design: Retrospective cohort study. Setting: Kaiser Permanente Northern California, Washington, and Colorado. Patients: Those distributed a FIT kit during January to September 2022. Measurements: FIT completion within 3 months, FIT positivity, receipt of colonoscopy within 3 months after a positive FIT result, and colonoscopy yield. Results: A total of 267 732 FIT kits were distributed: 213 928 (79.9%) to patients aged 45 to 49 years, and 53 804 (20.1%) to those aged 50 years. Overall, FIT completion was slightly higher in patients aged 45 to 49 years (38.9% vs. 37.5%; adjusted risk ratio [aRR], 1.05 [95% CI, 1.04 to 1.06]), although at Colorado, those aged 45 to 49 years were substantially less likely to complete a FIT (30.7% vs. 40.2%; aRR, 0.77 [CI, 0.73 to 0.80]). Overall, FIT positivity was lower in patients aged 45 to 49 years (3.6% vs. 4.0%; aRR, 0.91 [CI, 0.84 to 0.98]), and receipt of colonoscopy after a positive FIT result was similar between groups (64.9% vs. 67.4%; aRR, 1.00 [CI, 0.94 to 1.05]). Adenoma detection was lower in the younger group (58.8% vs. 67.7%; aRR, 0.88 [CI, 0.83 to 0.95]). Yields were similar for adenoma with advanced histology (13.2% vs. 15.9%; aRR, 0.86 [CI, 0.69 to 1.07]), polyp with high-grade dysplasia (3.4% vs. 5.1%; aRR, 0.68 [CI, 0.44 to 1.04]), sessile serrated lesion (10.3% vs. 11.7%; aRR, 0.92 [CI, 0.71 to 1.21]), and CRC (2.8% vs. 2.7%; aRR, 1.10 [CI, 0.62 to 1.96]). Limitation: The small number of neoplasia events contributed to wide CIs. Conclusion: Similar FIT completion and yield rates in people aged 45 to 50 years support initiation of CRC screening at age 45 years. Primary Funding Source: Kaiser Permanente Sidney R. Garfield Memorial Fund. Competing Interests: Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M24-0743.
Databáze:	MEDLINE
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