A new study supports the decision made by a powerful US medical group in 2021 regarding colonoscopies. This action has also affected Latin America and the Caribbean, which are seeing the same alarming trend.

In response to rising colorectal cancer incidence rates in adults under 50 years, the US Preventive Services Task Force (USPSTF) updated its guidelines to recommend that average‑risk adults begin colorectal cancer screening at age 45. Traditionally, these screenings began at age 50.

For this study, scientists reviewed data from screening colonoscopies done between 2021 and 2024 at Kaiser Permanente Northern California, a large healthcare system that provides comprehensive inpatient and outpatient services to more than 4.5 million members in northern California.

During this period, a total of 12,031 patients underwent a colonoscopy; 4,380 were between the ages of 45 and 49, and 7,651 were between 50 and 54. Women made up 47.3% of the overall cohort, and 42.8% of participants were non‑Hispanic White. The mean body mass index was 26.5, and 24% of participants had a history of smoking. (Asian Americans represented 30.4% of the study cohort, a larger proportion than in the general population, which could impact generalization of the findings, said the researchers in the paper.)

Although screening colonoscopy outcomes were generally slightly less frequent in the younger age group than in the older one, the tests showed comparable detection rates between the age groups for advanced and sessile serrated lesions. This study supports the revised recommendations on the age to initiate screening.

The article did not observe significant differences in neoplasia prevalence by sex between the age groups.

The researchers say that we must remain vigilant: time and statistics will tell whether it was the right move to change the colonoscopy screening age. As the article’s conclusion says: “Let’s say that 10 years go by and we observe a reduction in colon cancer incidence and mortality compared to people ages 45‑49 who did not undergo screening tests. Those data will tell us whether it was the right decision.”

Colorectal cancer is one of the most common cancers and a leading cause of death in the Region.

In 2024, this type of cancer was one of the most significant noncommunicable disease‑related health issues in Latin America. Rates are on the rise, especially among young adults.

The incidence of this cancer has steadily increased in recent years. In 2022, Latin America and the Caribbean saw 225,985 colorectal cancer diagnoses, with 61,056 deaths.

This cancer is the third leading cause of death overall and the number one cause of death from cancer. The Region faces challenges in collecting data and allocating resources, which affect the comprehensiveness of statistics. But perhaps the biggest challenge is ensuring widespread access to screening tests so that abnormal cells can be caught before they turn into cancer.

Patients should know that 90% of colorectal cancer cases originate from a lesion called a polyp. A polyp can take up to 15 years to turn into cancer. A colonoscopy done during this period can detect these polyps and remove them, thereby eliminating the possibility of cancer.

Studies on colorectal cancer screening programs in Latin America are unequal due to the lack of resources to sustain programs on a national scale. Uruguay launched the first colorectal cancer screening program in the Region in 2005. Since then, Brazil, Mexico, Argentina, Chile, and other countries have developed national screening guidelines and specific programs.

In Costa Rica, the government launched the “National Standard for Colorectal Cancer Care in Costa Rica” in 2025 to “define public health guidelines to be followed by Costa Rican health services in order to ensure access, quality, equality, and equity and thereby promote the implementation of effective early detection programs for colorectal cancer.”

Another example is Panama, which has a National Strategic Plan for Cancer Prevention and Control with concrete objectives for screening access through 2029.