American Cancer Society recommends earlier colorectal cancer screening

This undated microscope image provided by the NCI Center for Cancer Research shows human colon cancer cells with the cell nuclei stained red

The American Cancer Society has lowered the age to start screening for colon cancer. The organization now recommends adults 45 and older with an average risk of colorectal cancer undergo regular screening with either a high-sensitivity, stool-based test or a visual exam, depending on the patient's preference and test availability.

Although colorectal cancer rates have declined over the past two decades in people age 55 and older due to screening, there has been a 51 percent increase in colorectal cancer among those under 50 since 1994, the report says.

This new guideline could be as effective against colon cancer for the young as it was for those who are older. "Lowering the starting age is expected to benefit not only the segments of the population who suffer disproportionately from CRC - blacks, Alaska Natives, and American Indians - but also those individuals otherwise considered to be at average risk".

"But as we saw data pointing to a persistent trend of increasing colorectal cancer incidence in younger adults, including American Cancer Society research that indicated this effect would carry forward with increasing age, we chose to reevaluate the age to initiate screening in all USA adults".

A group representing three professional societies of gastroenterologists said in 2017 that African Americans should start screening at 45, because they are at increased risk, but that others should wait until age 50. "If screening had started five years earlier, my cancer might have been caught at the really early stages and not been as advanced as it was". We plan to invest $10 million in critical research by 2021, which will include learning why we are seeing an increase in young-onset colorectal cancer, doubling the number of constituents we serve, and saving 100,000 lives by 2026 through increased screening.

Many researchers believe that diet and exercise are linked to colon cancer, but Dr. Baber said nobody knows yet why it is showing up more frequently in younger patients. Fight Colorectal Cancer (Fight CRC) has been following and supporting research efforts examining early-age colorectal cancer for many years. "So that may be one associated factor", Chang said. Dr. Ahnen joined the National Colorectal Cancer Round Table (NCCRT) in 2009, has co-chaired the Family History Task Force since 2012 and joined the NCCRT Steering Committee in November of 2014.

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The current study worked with the MISCAN model, adjusting the lifetime incidence of colorectal cancer to reflect the most current data, which includes higher incidence younger in the lifespan.

"Even if you're younger, if you're noticing that there's a change in your bowel habits or your stools and that something isn't right, then see your doctor", he said.

The new guidelines also call for screening through the age of 85, rather than stopping at 75.

If this new guideline is adopted, lives will be saved.

Since adults in their 40s are far less likely to be screened than those in their 50s, the true underlying risk in adults between 45 and 49 likely is closer to the risk in adults between 50 and 54 than the most recent age-specific rates would suggest, studies say.

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