National guidelines recommend regular screening for colorectal cancer (CRC) begin at age 50. Recent research however showed rates rising among adults below the age of 50 despite declining overall rates of CRC. Screening guidelines have not been updated to reflect new findings. Younger individuals may not be aware of their CRC risk and providers may be unaware of the need to screen younger patients.

An online survey of individuals between the ages of 24 and 45 was conducted in April and May of 2018 using Amazon© Mechanical Turk. Measures collected included perceived CRC risk and susceptibility, screening knowledge, and understanding of screening results. Analysis I examined these variables by generational cohort. Analysis II randomized participants to receive one of two fictional colonoscopy result reports, the first being the standard of care report provided by a medical center in Maryland and the second a modified report containing a “gist” synthesis of findings. Mixed methods examined participants’ interpretations of these reports. Analysis III randomized participants to receive one of two statements describing trends in the rates of colon cancer to examine participants’ ability to discern false and true information.

Analysis I found Gen-Xers more likely to report higher perceived risk (general cancer and CRC) and severity (general cancer) and be aware of current CRC screening guidelines. Both groups displayed a lack of awareness of CRC screening methods. Analysis II showed that individuals who received the gist report correctly rated the report as more serious and the importance of follow-up higher than those who received the standard medical report. Analysis III revealed a lack of knowledge among participants to differentiate between correct and incorrect statements regarding colon cancer trends, with participants defaulting to accepting the validity of the statement.

Findings revealed gaps in knowledge of recommended screening activity and available screening methods. Providers should be prepared to discuss available screening options and accurate risk information; in addition, providers should discuss with patients which medical information they read online and remind individuals to take a more critical stance. CRC screening reports that contain a synthesis of findings may help patients plan next steps accordingly.