Thinking you could wait till your 50th birthday to worry about colorectal cancer? Maybe not.
New guidelines from the American Cancer Society recognize recent studies that have found increasing rates of colorectal cancer among younger people. In response, they lowered the recommended age to begin screening from 50 to 45.
Hardiman, surgical director of the Rogel Cancer Center’s Multidisciplinary Colorectal Cancer Clinic, cites a recent study cautioning that early onset colorectal cancer also tends to be more advanced when diagnosed and more likely to involve the rectum.
“We regularly see younger patients who have never had a colonoscopy, despite symptoms of more advanced disease like bleeding. Earlier screening might have detected their cancers before they experienced symptoms. For prevention, we know that colonoscopy, which identifies suspicious polyps and guides their removal, prevents about 90 percent of colorectal cancers,” she says.
Regardless of the recommended screening age, anyone with worrisome symptoms, such as bleeding, pain or changes in bowel habits, should talk with their doctor about further evaluation with colonoscopy.“The important message is that people should have a conversation with their doctor about their family history of cancer to examine their risk for colorectal cancer and determine the best age to start screening,” says Elena Stoffel, M.D., MPH, assistant professor of internal medicine at the Michigan Medicine and director of the Cancer Genetics Clinic at the Rogel Cancer Center.
These individuals are considered at higher risk for colorectal cancer and should talk with their doctor about screening with colonoscopy before age 50.
Adults at average risk of colorectal cancer should undergo regular screening with either a high‐sensitivity stool‐based test or a structural (visual) examination, depending on patient preference and test availability.
Screening options include:
All positive results from screening tests other than colonoscopy should be followed up with timely colonoscopy.
Additional American Cancer Society recommendations: