Abstract IA10: Progress in colorectal cancer screening: Past, present, and future

Abstract

Abstract Colorectal cancer (CRC) is the third most commonly diagnosed cancer and second leading cause of cancer-related death among men and women in the US, but it is largely preventable with screening. The implementation of screening programs, in addition to risk factor modification and, to a lesser degree, improvements in treatment, have contributed to a downward trend in CRC incidence and mortality rates for greater than three decades. However, the burden of disease has and continues to be unequally distributed. Striking disparities by race, ethnicity, socioeconomic status, and geography persist. Such differences are multifactorial and are, in part, driven by variation in screening access, uptake, adherence, and abnormality follow-up. There is a growing body of evidence that outreach, patient navigation, provider education, and multilevel population health strategies to address these challenges are effective. Intensifying such efforts and promoting earlier initiation of screening in high-risk populations are other promising yet controversial approaches. A recent change in the American Cancer Society guideline recommendations to lower the age for initiation of screening from 50 to 45 is being heavily debated—one concern being the potential unintended consequence of exacerbating existing disparities in CRC outcomes. Moreover, there is a dire need for a risk-stratification model that will determine CRC risk and the age at which individuals should begin screening more accurately than our current guideline models of family and personal medical history. Personalized prescriptions for screening are the future, and we are getting closer to this being a reality. Yet, while these are necessary, it is unclear if they will be sufficient to eliminate the observed disparities. Citation Format: Darrell M. Gray II. Progress in colorectal cancer screening: Past, present, and future [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr IA10.