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

Targeting the engine room of the cancer cell

June 18, 2018
Researchers at Columbia University Irving Medical Center (CUIMC) have developed a highly innovative computational framework that can support personalized cancer treatment by matching individual tumors with the drugs or drug ...

Researchers create novel combination as potential therapy for high-risk neuroblastoma

June 18, 2018
Researchers at VCU Massey Cancer Center in Richmond, Virginia, have identified a promising target to reverse the development of high-risk neuroblastoma and potentially inform the creation of novel combination therapies for ...

Study suggests well-known growth suppressor actually fuels lethal brain cancers

June 18, 2018
Scientists report finding a potentially promising treatment target for aggressive and deadly high-grade brain cancers like glioblastoma. But they also say the current lack of a drug that hits the molecular target keeps it ...

Standard myelofibrosis drug can awaken 'dormant' lymphoma

June 18, 2018
Most patients with myelofibrosis, a rare chronic disorder of the haematopoietic cells of the bone marrow, benefit from drugs from the JAK2 inhibitor class: symptoms are relieved, survival extended and general quality-of-life ...

Genomics offers new treatment options for infants with range of soft tissue tumors

June 18, 2018
The genetic causes of a group of related infant cancers have been discovered by scientists at the Wellcome Sanger Institute, the University of Wuerzburg and their collaborators. Whole genome sequencing of tumours revealed ...

Breast cancer researcher warns against online genetic tests

June 18, 2018
We have never been so fascinated by the secrets inside our cells.

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.