American Cancer Society recommends earlier colorectal cancer screening

Colorectal cancer screenings should start at 45 new guidelines say

Colon cancer screening should begin at 45-American Cancer Society

Screenings should begin at age 45, according to new guidelines the American Cancer Society released Wednesday.

"There is compelling evidence that the optimum age to start is now 45", Dr. Richard Wender of the ACS told NPR, noting a sharp increase in deaths from colon and rectal cancers among men and women under age 50. The change comes in response to a 51 percent rise in colon and rectal cancers since 1994 in adults younger than 50.

"As a practitioner, we've been seeing colon cancer in younger and younger people over the last 10 or 15 years", said Dr. John Tyler Baber, a gastroenterologist for CHI St. Vincent.

Wolf is a part of the society's Guideline Development Group, which reviews new research and tries to weigh the advantages of cancer screenings against their potential side effects or harm. They do not call for everyone to have a colonoscopy, the gold standard of colon cancer screening.

"Colon cancer is one of the most preventable scenarios that you can actually have".

"The American Cancer Society should be praised for taking a critical step toward helping more Americans get screened for colorectal cancer and potentially detecting the disease earlier", said Exact Sciences CEO Kevin Conroy.

"There's no way I would've ever imagined being here at 35", Michael Fiske said. "Colorectal cancer is really reaching into younger and younger populations".

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The group said the initial test does not have to be a colonoscopy, but instead could be one of several non-invasive tests, such as a home stool test available by prescription.

Currently, USPSTF, a government-backed independent panel that assesses the evidence for medical procedures, recommends screening from the age of 50.

The American Cancer Society has said that colon cancer screening should begging earlier than age 50, due to an uptick in colorectal tumors among younger people. Since adults in their 40s are far less likely to be screened than those in their 50s (17.8% vs. 45.3%), the true underlying risk in adults aged 45-49 years is likely closer to the risk in adults ages 50 to 54 than the most recent age-specific rates would suggest.

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. It's a polyp. And nearly all colorectal cancers develop from polyps.

According to Elena Ivanina, a gastroenterologist at Lenox Hill Hospital in NY, the 51 percent increase in colorectal cancer among those under age 50 since 1994 is an "alarming" trend.

"They go all the way to your appendix and the large bowel, and on the way back out they can take away polyps and lumps and bumps and a biopsy", said Dr. Gerald Fitzgerald with Fitz Tropics Family Care of the colonoscopy. "We would like to see it (guidelines) be even lower, but this is a victory for sure". And some will cover stool testing, but refuse to cover follow-up colonoscopies for those with abnormal results, he said.

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