• Press Release

AMSURG and Mount Sinai Health System Release New Research on Early-Onset Colorectal Cancer

Findings Support Recommendations to Lower Average Screening Age to 45

  • (May 24, 2021)

AMSURG, a division of Envision Healthcare and a national leader in outpatient care, and Icahn School of Medicine at Mount Sinai, world-renowned for its groundbreaking research, released new findings on colorectal cancer (CRC), which support several recommendations to lower the screening age from 50 to 45 for people who are at average risk for CRC. The findings were presented at the Digestive Disease Week® 2021 virtual scientific meeting on May 23.

The Mount Sinai team analyzed approximately 3 million colonoscopies performed at more than 120 AMSURG ambulatory surgery centers across the country in the last six years. The study specifically looked at de-identified data from patients aged 18 to 54 who received a screening or diagnostic colonoscopy and were not undergoing a colonoscopy to monitor previously detected polyps, cancer, inflammatory bowel disease or genetic conditions predisposing to cancer. Results show:

  • Colorectal cancer was detected in 0.58 percent of patients aged 45 to 49 and in 0.53 percent of patients aged 40 to 44
  • Polyps that had the greatest possibility of becoming cancerous were found in 7.5 percent of patients aged 45 to 49 and in 5.8 percent of patients aged 40 to 44
  • A significant portion of patients had polyps present even if they did not have a documented family history of colorectal cancer

“These findings are significant and can make a meaningful difference in the healthcare system's ability to save patients’ lives. With early and routine colonoscopies, we can prevent polyps from becoming cancerous and even detect and remove cancerous polyps while giving patients a better chance of recovery and survival. These data support efforts to begin screening at age 45 and communicate the importance of on-time screening by early messaging to patients and providers,” said John Popp, MD, Medical Director for AMSURG.

Colorectal cancer is the second leading cause of cancer death in the U.S. and one of the most preventable. The incidence of CRC in patients under 50 has nearly doubled since the early 1990s.[1] Consensus in the medical community is building that patients who are at average risk for CRC should begin screening at age 45.

“This study can inform additional research directed at CRC screening in younger populations. More importantly, it helps physicians inform patients about the importance of early screening several years before they reach screening age; we believe that this will encourage younger patients to get routine screenings on time, at the appropriate age, and with close attention to the individual’s risk factors and symptoms,” said primary investigator, Steven Itzkowitz, MD, Professor of Medicine, Oncological Sciences and Medical Education, and Director of the GI Fellowship Program at Icahn School of Medicine at Mount Sinai.

Risk factors include a family history of CRC or pre-malignant polyps, inflammatory bowel disease and lifestyle habits, such as diet, smoking and obesity. CRC also disproportionately impacts the Black community. While symptoms are not always easy to recognize, they can include a change in bowel habits, such as diarrhea and constipation. Additionally, rectal bleeding, abdominal discomfort or a feeling that the bowel does not completely empty can be a cause for concern. Individuals are urged to listen to their bodies and consult their physicians if they have questions or require medical care.

As a leading provider of colonoscopies, AMSURG submits a larger colonoscopy dataset than any provider to a national endoscopic registry called the GI Quality Improvement Consortium (GIQuIC).
The AMSURG data reviewed for this study was obtained from the registry.

This research on CRC trends in the United States is the first of an ongoing collaboration between AMSURG and Mount Sinai.



AMSURG acquires, develops and operates ambulatory surgery centers (ASC) in partnership with physicians throughout the United States. As of January 1, 2021, AMSURG operates and holds ownership in more than 250 ASCs in 34 states and the District of Columbia with medical specialties ranging from gastroenterology to ophthalmology and orthopaedics. To learn more about AMSURG, a division of Envision Healthcare Corporation, visit www.amsurg.com.

About Envision Healthcare Corporation

Envision Healthcare Corporation is a leading national medical group that delivers physician and advanced practice provider services, primarily in the areas of emergency and hospitalist medicine, anesthesiology, radiology/teleradiology, and neonatology to more than 1,800 clinical departments in healthcare facilities in 45 states and the District of Columbia. Post-acute care is delivered through an array of clinical professionals and integrated technologies which, when combined, contribute to efficient and effective population health management strategies.

As a leader in ambulatory surgical care, the medical group operates and holds ownership in more than 250 surgery centers in 34 states and the District of Columbia, with medical specialties ranging from gastroenterology to ophthalmology and orthopaedics. In total, the medical group offers a differentiated suite of clinical solutions on a national scale with a local understanding of our communities, creating value for health systems, payers, providers, and patients. For additional information, visit www.envisionhealth.com.

[1] Stoffel EM, Murphy CC. Epidemiology and mechanisms of the increasing incidence of colon and rectal cancers in young adults. Gastroenterology. 2020;158(2):341-353.

About the Mount Sinai Health System

Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with 48,000 employees working across eight hospitals, more than 400 outpatient practices, more than 600 research and clinical labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time—discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it.

Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients’ medical and emotional needs at the center of all treatment. The Health System includes approximately 9,000 primary and specialty care physicians and 11 free-standing joint-venture centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida. Hospitals within the System are consistently ranked by Newsweek’s® “The World’s Best Smart Hospitals, Best in State Hospitals, World Best Hospitals and Best Specialty Hospitals” and by U.S. News & World Report's® “Best Hospitals” and “Best Children’s Hospitals.” The Mount Sinai Hospital is on the U.S. News & World Report® “Best Hospitals” Honor Roll for 2023-2024.

For more information, visit https://www.mountsinai.org or find Mount Sinai on FacebookTwitter and YouTube.