New guidelines recommend earlier colon cancer screening


The ACS's new guidelines suggest that all healthy adults should start getting screened for colon and rectal cancers at age 45 instead of 50 and continue doing so through at least age 75.

For now, the task force still strongly recommends people begin screening at age 50.

Exact Sciences Chief Executive Officer Kevin Conroy said Cologuard is a cheaper way to screen younger people.

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.

The new guideline does not prioritize among screening test options. For patients older than 86, the ACS discourages screening.

The American Cancer Society is the first organization that has recommended colon cancer screening begin earlier for average-risk men and women of all races and ethnicities. "You are talking about screening 21 million extra individuals". Health officials also recommend sitting down with your doctor.

"We know from trials that if you offer a choice between colonoscopy and a less-invasive test, that more people will opt to be screened, which is our goal in the end", he said. "The evidence is now absolutely clear, and I can't emphasize how carefully this was done". That change has been attributed to healthy lifestyle changes and more widespread screening.

What explains the rise in colorectal cancer? "This appears to be a real phenomenon".

Researchers with the cancer society found a 51 percent increase in colorectal cancer among those under the age of 50 since 1994. After reviewing the data, experts concluded that a beginning screening age of 45 for adults of average risk will result in more lives saved from colorectal cancer.

Consuming red meat, processed meat and alcoholic beverages, among other factors, could increase the risk of colorectal cancer.

Doctors will probably look to specialty medical societies to sort out the different guidelines, said Dr. Marcus Plescia, of the Association of State and Territorial Health Officials. 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.

Dr. Nilofer Saba Azad, associate professor of oncology at Johns Hopkins Medicine in Baltimore, agrees with the newly updated guidelines.

"You just have to get over it". A potential harm from screening tests also remains unclear: For instance, harm can be caused by people being wrongly allocated to the risk group, causing unnecessary psychological stress.

"If either assumption doesn't hold true, then earlier screening could fail to improve colorectal cancer mortality in real life, no matter what the models say", Lin said.