Don't Wait Till 50 for Your Colon Cancer Screening

Colon cancer screening should begin at 45-American Cancer Society

Colon cancer screening should begin at 45-American Cancer Society

So, if you're in your mid-40s, don't be alarmed if this is mentioned at your next doctor visit.

The group said people should get a colonoscopy at age 45 instead of the previous recommendation of 50.

"The revision to the American Cancer Society guideline for the average risk population from 50 to 45 is a critical step to impact the increasing rate of colorectal cancer in the young (under age 50)".

"There is compelling evidence that the optimum age to start is now 45", Dr. Richard Wender of the ACS told NPR, noting a sharp increase in deaths from colon and rectal cancers among men and women under age 50.

The numbers: this year more than 130,000 people be diagnosed with colorectal cancer, and more than 50,000 will die from it.

The experts cite a worrisome rise in the number of younger adults diagnosed with the nation's third leading cause of cancer deaths. It's a polyp. And nearly all colorectal cancers develop from polyps.

The organization says it's seen an increase in young people getting colon cancer recently.

While few trials have looked at screening 45-year-olds, new statistical models reviewed by the cancer society showed that the younger group should benefit almost as much as slightly older adults do, Wolf said. "It's what we call a birth cohort effect. It's showing up younger and no one knows why", Dwyer says. On the other hand, if screening started at age 60, you'd have minimal burden but also minimal benefit - we would be missing some cancers and finding others too late.

That's one reason the cancer society and preventive services task force recommend screening be considered on a case by case basis after age 75 and stopped after age 85. These studies provided no answers to the research question of the rapid report, however: Due to a lack of new findings, benefit or harm of the screening for people under the age of 55 years with a family history remain unclear.

Typically, these home stool blood tests are repeated every year for good results. The new guideline does not prioritize among screening test options.

The ACS published the guidelines online May 30 in its journal CA: A Cancer Journal for Clinicians.

Doctors will probably look to specialty medical societies to sort out the different guidelines, said Dr. Marcus Plescia, of the Association of State and Territorial Health Officials. "The evidence is now absolutely clear, and I can't emphasize how carefully this was done. I think that lowering the screening age to 45 will pick up lesions earlier and hopefully mimic - and certain projections agree - what has been accomplished in people over 50". "But those things do not fully explain the rise".

"But as we saw data pointing to a persistent trend of increasing colorectal cancer incidence in younger adults, including American Cancer Society research that indicated this effect would carry forward with increasing age, we chose to reevaluate the age to initiate screening in all USA adults". It updated its colon cancer guidelines in 2016 and its next review isn't expected until around 2021. However, there has been a 51% increase in CRC among those under age 50 since 1994. "Therefore, what we've observed with the rising incidence is not simply a result of detection bias", Chang said. Many of them did not have traditional risk factors such as obesity, smoking, alcohol, physical inactivity or a diet high in fat or low in fiber. "That's the public health statement, which is, pay attention to your bowels, and seek medical care if things don't seem right, if there's blood in your stools or your bowel habits change suddenly".

But the ACS commissioned a "modeling" study in developing the new guidelines.

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