Colon cancer screening should begin at 45-American Cancer Society

Randy Kelley
June 2, 2018

The American Cancer Society has changed its colorectal cancer screening guidelines.

The American Cancer Society's newly updated guidelines for colon and rectal cancer screening recommend that adults at average risk get screened starting at age 45 instead of 50, as previously advised.

"Moving the start of screening back to age 45 for the average risk population is a considerable change", says Andrea (Andi) Dwyer, director of the Colorado Colorectal Screening Program at the University of Colorado Cancer Center and program director at the Colorado School of Public Health.

In 2014, 43 percent of colorectal cancer cases in those under 50 were in adults ages 45 to 49, according to Rebecca L. Siegel, an epidemiologist with the American Cancer Society and the lead author of several reports showing a rise in colorectal cancers in adults as young as their 20s and 30s.

"We're deeply concerned about this trend", says Dr. Richard Wender of the American Cancer Society.

Wolf is a part of the society's Guideline Development Group, which reviews new research and tries to weigh the advantages of cancer screenings against their potential side effects or harm.

Georges was in the spotlight this year after participating in the national One Million Strong movement to improve awareness of and screening for colorectal cancer. "Therefore, what we've observed with the rising incidence is not simply a result of detection bias", Chang said.

The Colorectal Cancer Alliance established the Never Too Young Advisory Board so we may all join forces and take action around the issue of young-onset colorectal cancer.

For colorectal cancer, the American Cancer Society didn't push one screening option over another but listed various options: High-sensitivity stool tests, created to detect blood in feces, which need to be administered every year; a DNA stool test, sold under the brand name Cologuard, every three years; a colonoscopy, every 10 years; or a virtual colonoscopy or flexible sigmoidoscopy, every five years. The ACS has more information on colorectal cancer risk factors on its website. "Whether it's 45 or 50, the most important thing is for people to get screened and keep screening". But not everyone agrees with a starting age of 45.

Colorectal cancer is the fourth-most-common cancer diagnosed among adults in the United States. But since 1994, there has been a 51 percent increase in colorectal cancer among those under age 50. "We're getting [cancers] when they're polyps, before they even become cancer, or we're getting cancers earlier and decreasing the mortality. There is excellent evidence that we are doing the right thing".

The ACS paper said colonoscopies, visual tests and a high-sensitivity stool-based test are effective means of detecting colorectal cancer.

Such risks include false-negative or false-positive results, as well as rare complications or feelings of anxiety with more invasive testing approaches, such as colonoscopy.

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