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

Findings Support Recommendations to Lower Average Screening Age to 45

NEW YORK & NASHVILLE, Tenn.--()--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

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

About the Mount Sinai Health System

The Mount Sinai Health System is New York City's largest academic medical system, encompassing eight hospitals, a leading medical school, and a vast network of ambulatory practices throughout the greater New York region. Mount Sinai is a national and international source of unrivaled education, translational research and discovery, and collaborative clinical leadership ensuring that we deliver the highest quality care—from prevention to treatment of the most serious and complex human diseases. The Health System includes more than 7,200 physicians and features a robust and continually expanding network of multispecialty services, including more than 400 ambulatory practice locations throughout the five boroughs of New York City, Westchester, and Long Island. The Mount Sinai Hospital is ranked No. 14 on U.S. News & World Report's "Honor Roll" of the Top 20 Best Hospitals in the country and the Icahn School of Medicine as one of the Top 20 Best Medical Schools in country. Mount Sinai Health System hospitals are consistently ranked regionally by specialty by U.S. News & World Report.

For more information, visit or find Mount Sinai on Facebook, Twitter and YouTube.

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.

Release Summary

AMSURG and Mount Sinai Health System release new research on early-onset colorectal cancer.