ACS Lowers Age for Colorectal Cancer Screening Guideline

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"There is compelling evidence that the optimum age to start is now 45", says Dr. Richard Wender, chief cancer control officer of the society, who cites a sharp increase in deaths from colon and rectal cancers among men and women under age 50.

The rate of colorectal cancer among the 50-to-54 age group, even with a decline over the past several years, remains higher than among those who are 45 to 49; that partly reflects the start of screening at 50, which leads to detection of the disease and allows people in the older group to be identified as having colorectal cancer.

Despite the high cure rate when colon cancer is caught early, only one-third of the Americans over 50 get screened.

Average-risk adults in good health with a life expectancy of greater than 10 years should continue colorectal cancer screening through age 75.

The guideline suggests screening either through a high sensitivity stool-based test or visual examination such as colonoscopy that snakes a tiny camera through the rectum to view the colon to search for abnormal tissue growth.

Across America, our Never Too Young Advisory Board will work tirelessly to educate primary care physicians and gastrointestinal medical professionals around symptoms of young-onset colorectal cancer.

"We know that obesity's associated with an increased incidence of many cancers, including colorectal cancer, and the obesity epidemic remains an important and growing problem in the US".

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Doctors aren't sure why colorectal cancers are increasing in younger adults.

"I went in there not thinking there's going to be a problem, and I wake up with two doctors standing over me saying, 'We have an issue, '" said Fritsche, a competitive athlete who said he follows a healthy diet and has no family history of colon cancer. As a result, testing could be offered earlier or more often in groups of people at risk (risk-adapted screening). But not everyone agrees with a starting age of 45.

Finding the factor or factors driving the development of colorectal cancer in young patients could be key in preventing the disease.

She said rates are not only increasing among people in their 40s, but also among those in their 20s and 30s (though the incidence at those ages remains low). Signs of colorectal cancer may include a change in bowel habits, such as diarrhea or constipation, that lasts more than a few days; rectal bleeding; and cramping or abdominal pain. "There is excellent evidence that we are doing the right thing".

The younger start data for colorectal cancer screening puts the ACS at odds with the U. S. Preventive Services Task Force (USPSTF), which stayed with its recommendation of initial screening at age 50 in an update published in 2016. The new guideline does not prioritize among screening test options. But he noted that younger people are also at increased risk. "So it's preventative, not just early diagnosis", she said, adding that she thinks the risks of screening younger outweigh the benefits.

"Colon cancer's not supposed to happen to people that are less than 50, under 30 or 35 and below its really supposed to be more like a no chance", Fiske said.

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