Colorectal cancer screening in young adults: an analysis of the evidence for lowering the screening age

Abstract

Introduction: Early-onset colorectal cancer (CRC) has shown a sustained global increase in incidence, challenging the paradigm that this neoplasm predominantly affects the elderly. Young adults often face late diagnoses and tumors with more aggressive biology. Objective: To analyze scientific evidence from the last ten years that supports lowering the CRC screening age to 45 and discuss its impact on quality of life. Methods: A qualitative and exploratory literature review was conducted in PubMed, LILACS, and ScienceDirect databases, covering the period from 2013 to 2023. The final sample consisted of 28 articles selected through rigorous eligibility criteria. Results and Discussion: The findings consolidate the influence of a Westernized lifestyle and metabolic factors on early carcinogenesis. Lowering the screening age has proven cost-effective, allowing detection at early stages and less invasive treatments. Early diagnosis is crucial for preserving quality of life, including reproductive health and the socioeconomic functionality of young adults. Primary care was identified as playing a vital role in overcoming diagnostic delays. In Brazil, the use of non-invasive tests (FIT) emerges as a strategy to democratize access. Conclusion: Anticipating screening is an ethical and clinical imperative to curb CRC mortality in young people. The implementation of more inclusive protocols is fundamental to protecting the dignity and life projects of this population, requiring public policies adapted to the Brazilian healthcare reality.