Should Flanders consider lowering its target age for colorectal cancer screening to 45-49?

INTRODUCTION:Colorectal cancer (CRC) screening generally starts screening by the age of 50 based on guidelines. Lately however, a U.S. guideline recommended to start CRC screening from age 45 and, very recently, two studies were published that addressed young-onset in Europe (in part) (Vuik et al., 2019; Araghi et al., 2019). MATERIALS AND METHODS:Flemish CRC incidence and mortality data contextualise trend results for age groups under 50 and what the implications could be for practice. RESULTS:CRC incidence rates showed considerable variability over a 12-year period without a clear increase in disease burden for the age group 45-49 in Flanders. In several age groups under 39 an increasing incidence trend was visible for both genders. Data was analysed in a period where no CRC screening was present in Flanders. DISCUSSION:Decreasing the target age for the Flemish CRC screening does not seem to be straightforward and primary prevention should be considered more prominently.