Colon cancer screening should begin at 45: US doctors

May 31, 2018
Cancer — Histopathologic image of colonic carcinoid. Credit: Wikipedia/CC BY-SA 3.0

Screening for colon cancer should begin earlier, at age 45 instead of 50, due to an uptick in colorectal tumors among younger people, the American Cancer Society said on Wednesday.

The new guidelines came after research showed a 51 percent increase in colorectal among people under 50 since 1994, and an accompanying rise in death rates.

"When we began this guideline update, we were initially focused on whether screening should begin earlier in racial subgroups with higher colorectal cancer incidence, which some organizations already recommend," said Richard Wender, chief cancer control officer for the American Cancer Society.

Groups known to suffer disproportionately high rates of colon cancer include African-Americans, Alaska Natives, and American Indians.

"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 decided to reevaluate the age to initiate screening in all US adults."

The new guidelines do not specify which kind of test people should get, but includes options such as a traditional colonoscopy—which should be done every 10 years—or high-sensitivity stool analysis which depending on the type, could be done every year to every three years.

Regular screening should continue until age 75, and "clinicians should discourage individuals over 85 from continuing ," because the risk of complications outweighs the benefits at that age, said the report.

Mysterious rise in cancer

Experts say it is unclear why colon cancer rates are on the rise in younger people.

Research shows that adults born around 1990 have twice the risk of colon cancer and four times the risk of rectal cancer than adults born around 1950, who have the lowest risk, said the report in CA: A Cancer Journal for Clinicians, a peer-reviewed journal of the American Cancer Society.

Meanwhile, colon cancer rates in people older than 55 are declining, largely due to screening and removal of precancerous polyps.

According to Elena Ivanina, a gastroenterologist at Lenox Hill Hospital in New York, the 51 percent increase in among those under age 50 since 1994 is an "alarming" trend.

"The reason for the increase is currently not known but possibly associated with obesity and sedentary lifestyles, heavy alcohol use and chronic inflammatory conditions, which are all on the rise," said Ivanina, who was not involved in crafting the guidelines.

She applauded the move toward earlier screening, saying it "will benefit the general public."

Another widely respected medical group which issues screening recommendations, the United States Preventive Services Task Force (USPSTF), decided not to recommended in 2016 that screening start at 45, saying any additional benefit would be "modest."

The American Cancer Society urged people to talk with their doctors about which kind of to pursue, based on risk factors like family history, diet, alcohol consumption and exercise patterns.

"I would say an actual colonoscopy would be the best for multiple reasons," David Bernstein, chief of hepatology at Northwell Health in New York, told AFP.

"It is the only one of those tests that actually prevents cancer. It allows you to find polyps before they become cancer."

Explore further: American Cancer Society updates colorectal cancer screening guideline

More information: Andrew M. D. Wolf et al, Colorectal cancer screening for average-risk adults: 2018 guideline update from the American Cancer Society, CA: A Cancer Journal for Clinicians (2018). DOI: 10.3322/caac.21457

Related Stories

American Cancer Society updates colorectal cancer screening guideline

May 30, 2018
An updated American Cancer Society guideline says colorectal cancer screening should begin at age 45 for people at average risk, based in part on data showing rates of colorectal cancer are increasing in young and middle-aged ...

As colorectal cancer rises in young people, new guidelines recommend screening start at 45

May 30, 2018
The American Cancer Society (ACS) and other preventive guideline organizations recommend that screening for colorectal cancer start for people of average risk at age 50. However, new data showing rising colorectal cancer ...

Technology advances help to prevent, lessen impact of colon cancer

March 14, 2017
Approximately 140,000 people are diagnosed with colorectal cancer in the U.S. each year. March is Colorectal Cancer Awareness Month.

Too many americans skipping colon cancer screening

March 2, 2012
(HealthDay) -- Approximately one in three U.S. adults between the ages of 50 and 75 who should be screened for colorectal cancer have not been, according to the American Society for Gastrointestinal Endoscopy.

Family history of colon cancer calls for earlier screening

March 21, 2017
(HealthDay)—If you've got a family history of colon or rectal cancers, you probably need to start screening for these conditions before you turn 50, a cancer expert says.

Colorectal cancer statistics, 2017

March 1, 2017
Despite dramatic reductions in overall colorectal cancer incidence and mortality, striking disparities by age, race, and tumor subsite remain. That's according to the latest edition of Colorectal Cancer Statistics and its ...

Recommended for you

Study involving hundreds of patient samples may reveal new treatment options of leukemia

October 17, 2018
After more than five years and 672 patient samples, an OHSU research team has published the largest cancer dataset of its kind for a form of leukemia. The study, "Functional Genomic Landscape of Acute Myeloid Leukemia", published ...

A 150-year-old drug might improve radiation therapy for cancer

October 17, 2018
A drug first identified 150 years ago and used as a smooth-muscle relaxant might make tumors more sensitive to radiation therapy, according to a recent study led by researchers at The Ohio State University Comprehensive Cancer ...

Loss of protein p53 helps cancer cells multiply in 'unfavourable' conditions

October 17, 2018
Researchers have discovered a novel consequence of loss of the tumour protein p53 that promotes cancer development, according to new findings in eLife.

Researcher fighting breast cancer with light therapy

October 17, 2018
When treatment is working for a patient who is fighting cancer, the light at the end of the tunnel is easier to see.

New method uses just a drop of blood to monitor lung cancer treatment

October 17, 2018
Dr. Tasuku Honjo won the 2018 Nobel Prize in physiology or medicine for discovering the immune T-cell protein PD-1. This discovery led to a set of anti-cancer medications called checkpoint inhibitors, one of the first of ...

Gene screening technique helps identify genes involved in a fatty liver-associated liver cancer

October 17, 2018
With an estimated twenty-thousand protein-coding genes in the human genome, pinpointing a specific gene or pathway responsible for a particular disease can be like finding a needle in the proverbial haystack. This has certainly ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.