Colorectal cancer (CRC) cases among adults under 50 are surging, with the sharpest rise in the 45–49 age group. The American Cancer Society reports CRC is now the leading cause of cancer death for men under 50 and the second for women. With screening guidelines lowered to age 45 in 2021, uptake is accelerating—forcing GI groups and ASCs to rethink operations.
Key Takeaways
1. Demand surge ahead
Screening among 45–49-year-olds jumped 62% from 2019–2023. Colonoscopy volumes rose 43%, while stool-based testing grew fivefold.
2. ASCs under pressure
GI already accounts for 28.3% of Medicare ASC procedures. With millions of new patients, ASCs may need to expand anesthesia coverage, slots, and recovery space.
3. Reimbursement squeeze
Despite higher volumes, payment rates haven’t kept pace. Colonoscopy/biopsy reimbursements are down 38% since 2007, raising financial strain.
4. Workforce shortage
By late 2025, the U.S. is projected to be short 1,600 gastroenterologists. Added demand risks longer wait times, provider burnout, and reliance on APPs.
5. Access gaps remain
Nearly 40% of adults 45+ still haven’t had a colonoscopy. Barriers include fear, cost, and lack of awareness—79% don’t know the current screening age. Community-driven free or low-cost programs are vital, but disparities persist.