Low colorectal cancer screening among adults aged 45-49 years in the US, 2023.

[OBJECTIVES] Colorectal cancer (CRC) screening has been recommended for US adults aged 45 to 49 years. This study examined the rate and predictors of CRC screening in 2023 among adults aged 45 to 49 years vs adults aged 50 to 54 years.

[STUDY DESIGN] Retrospective observational study.

[METHODS] All adults aged 45 to 54 years in the 2023 National Health Interview Survey were included. The rate of CRC screening was calculated for the age groups 45 to 49 years and 50 to 54 years. Multivariate logistic regression was used to examine the age group difference in CRC screening, controlling for sex, race/ethnicity, immigrant status (vs born in the US), college education, insurance (vs uninsured), and wellness visit within 1 year.

[RESULTS] The rate of CRC screening was significantly lower among adults aged 45 to 49 years than among adults aged 50 to 54 years (36.1% vs 55.6%; P  < .001). The age group difference in CRC screening persisted in multivariate logistic regression (aged 45-49 vs 50-54 years: OR, 0.44; 95% CI, 0.39-0.51). Other predictors of CRC screening included US born, college education, insurance, and wellness visit within 1 year. Sensitivity analysis on colonoscopy use confirmed these findings (aged 45-49 vs 50-54 years: OR, 0.48; 95% CI, 0.42-0.55).

[CONCLUSIONS] Less than half of US adults aged 45 to 49 years were up to date on CRC screening in 2023. Age group-specific interventions may improve CRC screening in the US.