Colon and rectal cancer screenings should start at 45, new guidelines say

Colorectal cancer screenings should start at 45 new guidelines say

"If everyone followed screening recommendations based on risk, we could cut colorectal cancer mortality by at least a half, with some estimates suggesting mortality would be cut up to 70 percent", she says.

Dr. Baber said he was not surprised it would issue the new guidelines.

Colon cancer signs can include persistent cramps and changes in bowel habits, along with bloody stools.

The qualified endorsement of screening at age 45 is reasonable and "will lead to a lot of discussion and investigation", said Douglas Rex, a professor of medicine at Indiana University. Previously, the recommended age to begin screenings is 50, but increased rates of cancer and death in those younger than 50 have encouraged health care providers to revise the starting age.

Dr. Robin B. Mendelsohn, a gastroenterologist at Memorial Sloan Kettering Cancer Center in NY, says there's been an "alarming" increase in cancer among younger adults.

"The bottom line is that if you regularly participate in colon cancer screening, you have a reduced risk of getting and dying from colon cancer", said Weinberg, who was not involved in the cancer society guidelines.

Cologuard is now approved for use in people with an average risk of colorectal cancer between the ages of 50 and 84. In 2018, there were more than 2,500 new cases of colon and rectal cancer diagnosed in Wisconsin. As part of the review process, the USPSTF took into account three computer simulations that considered different starting ages and screening intervals.

Cologuard is indicated to screen adults of either sex, 50 years or older, who are at typical average-risk for CRC. Historically, African-Americans, Native Americans and Native Alaskans have had higher rates of these types of cancer. Until then, Dwyer and colleagues offer the current recommendations with the intention of optimizing screening to find these cancers, even in younger patients, early enough to offer successful treatments.

"We're finding people that are marathon runners, people that are vegetarians, people that do everything right, and they're still being diagnosed as having colon cancer in their 40's", he said.

From 1994 to 2014, the rate of new colon and rectal cancer increased by 51 percent in those under 55.

But the ACS commissioned a "modeling" study in developing the new guidelines.

Some of the increase could stem from the increase in obesity in the US, a known risk factor for colorectal cancer, he says.

Regular screening should continue until age 75, and "clinicians should discourage individuals over 85 from continuing colorectal cancer screening", because the risk of complications outweighs the benefits at that age, said the report.

She said rates are not only increasing among people in their 40s, but also among those in their 20s and 30s (though the incidence at those ages remains low).

She applauded the move toward earlier screening, saying it "will benefit the general public".

"It's hard enough to get people to do it at all", Plescia noted.



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