Screening for colorectal cancer (CRC) in adults aged 50 years and older has reduced both new cases of and deaths due to CRC. However, among persons under age 50, sporadic (i.e., non-hereditary) CRC is on the rise. Lowering the age for starting to screen has been proposed, but limited information suggests that the harms and costs would outweigh the benefits. Another option is to identify a high-risk group among persons under age 50. This project will use electronic VA database and electronic medical record (EMR) review to compare cases (persons with non-hereditary CRC diagnosed prior to age 50) and controls (no CRC) on several candidate risk factors with the goal of creating a tool that identifies younger Veterans at high-risk who could be screened earlier than age 50. We will also compare human EMR review with automated ways of obtaining risk information from the EMR and other electronic databases to determine whether automated methods may be used to identify younger Veterans at high-risk for CRC.
