Colorectal cancer screenings should start at age 45, new guidelines say


The American Cancer Society changed its recommendation Wednesday for colorectal cancer screenings, saying adults should begin them at age 45 - not 50, as previously advised.

"Fight Colorectal Cancer commends the American Cancer Society's leadership announcing a significant change in the colorectal cancer screening guidelines for average-risk patients from 50 years of age to 45".

That means that "we hope that doctors will look at this and at least start discussions of colorectal cancer screening with their 45-year-old patients", Wolf said.

"I have seen first-hand the dangers of early onset colon cancer". "We hope to find pre-malignant polyps which have not even become cancerous yet", he said.

A prominent cancer organization is for the first time recommending Americans initiate colorectal cancer screening at age 45 instead of waiting until age 50, a threshold long endorsed by many other medical groups.

"The most common finding when you're screening is actually not cancer".

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.

"It's going up at a pretty alarming rate".

Dr. Andrew Wolf, the lead author of the latest guidelines, said they considered and rejected that reasoning.

"Everyone wants to say that it's the obesity epidemic, poor diet and lack of exercise", Wolf said.

Colorectal cancer is the fourth-most commonly diagnosed cancer among adults and the second-leading cause of cancer death, in the United States.

And past studies by Church and other researchers across the country, were used to come up with today's new guideline. The conclusion was that earlier screening had a better "benefit-risk ratio" than screening at age 50.

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

Getting a colonoscopy may not be at the top of anyone's to-do list, but it's the most effective way to detect and, in many cases, stop the disease before it progresses. Doctors also recommend stool blood tests, which are done every year.

The ACS is not recommending any particular approach. "People should be informed of all their choices".

The new guideline is partly based on data showing rates of colorectal cancer on the rise in young and middle-aged populations.

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

The group is in the process of updating its screening guidelines, a spokesperson said. One goal is to research the reasons for the rising incidence, said Dr. Andrea Cercek, an oncologist at Sloan Kettering. So, screening at age 45 does not address the whole issue, Cercek noted.

Signs and symptoms of colon cancer include diarrhea or constipation that last for more than a few days, a change in bowel movements, rectal bleeding, and abdominal pain.

"But the point is to have it checked out", she said. "It's very curable when we catch it early", Cercek said.

Analyst Brian Weinstein, with the William Blair investment firm, praised the American Cancer Society for its "forward thinking", but cautioned that the updated guideline may not be a big boost for Cologuard right away.