New guidelines recommend screening start at age 45 for colorectal cancer

Recommendations from the American Cancer Society were recently released stating that American adults at average risk should begin colon cancer screening at age 45 instead of age 50.  Just two years ago, an influential government advisory group had kept the age for colon cancer screening beginning at age 50.  This new recommendation from the American Cancer Society, updates the old recommendation.

What influenced this change was a study published last year that found alarming rising rates of colon cancer and deaths in people younger than 50.  Since 1994, there has been a 50 percent increase in cases of colon cancer in adults younger than age 50.  At the same time, colorectal cancer rates have steadily declined in people over age 55 because of screening. If caught early, colon cancer is typically considered more treatable.

It was after reviewing the data from this study, that experts on the American Cancer Society Guideline Development Committee concluded that a beginning screening age of 45 for average risk adults will result in more lives saved from colorectal cancer. The earlier colon cancer is discovered, the better chance a person has of beating it back.  These guidelines include the following recommendations:

·      People at average risk of colorectal cancer should start regular screening at age 45

·      People who are in good health and with a life expectancy of more than 10 years should continue regular colorectal cancer screening through age 75.

·      People ages 76 through 85 should make a decision with their medical provider about whether to be screened, based on their own personal preferences, life expectancy, overall health, and prior screening history.

·      People over age 85 should no longer get colorectal cancer screening

Certain people of a higher than average risk for colon cancer have a different set of guidelines and are recommended to start colorectal cancer screening before age 45, be screened more often, and/or get specific tests.  These people include:

·      Anyone with a strong family history of colorectal cancer or certain types of polyps

·      Anyone with a personal history of colorectal cancer or certain types of polyps

·      Anyone with a personal history of inflammatory bowel disease such as ulcerative colitis or Crohn’s disease

·      Anyone with a known family history of a hereditary colorectal cancer syndrome such as familial adenomatous polyposis or Lynch Syndrome

·      Anyone with a personal history of radiation to the abdomen or pelvic area to treat a prior cancer

The American Cancer Society endorses six kinds of screening exams, from inexpensive take-home stool tests performed every year to colonoscopies done every 10 years.  All of them are considered good but it is important for everyone to discuss with their healthcare provider about which tests might be the best options for them.  In order for these screening tests to be effective, they need to be repeated at regular intervals.  Anyone who uses a screening test other than a colonoscopy and has an abnormal reading must have a follow-up screening with a colonoscopy to complete the screening process.

Here are the six recommended colorectal cancer screening tests:

Stool-based tests:

·      Highly sensitive fecal immunochemical test (FIT) every year

·      Highly sensitive guaiac-based fecal occult blood test (gFOBT) every year

·      Multi-targeted stool DNA test (MT-sDNA) every 3 years

Visual exams:

·      Colonoscopy every 10 years

·      CT colonography (virtual colonoscopy) every 5 years

·      Flexible sigmoidoscopy (FSIG) every 5 years