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American Cancer Society recommends earlier colorectal cancer screening

02 June 2018

"The numbers showed that new cases of colorectal cancer are occurring at an increasing rate among younger adults", senior editor Stacy Simon wrote. Prior recommendations to catch slow-moving malignancies advised the start of regular checks at age 50, but a paper published by the ACS Wednesday said Americans should jump on it sooner.

When the group first was asked to review the screenings, Wolf said, they expected to lower the age only for specific groups.

Populations at high risk of colorectal cancer include African-Americans, Alaska Natives, Native Americans, and anyone with a family or personal history of rectal polyps.

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

Cologuard is now available to individuals age 50 and older who are at average risk for colorectal cancer. "Younger people are being diagnosed at under 50 and under 40 and under 30".

The influential Preventive Services Task Force decided against lowering the screening age to 45 when it updated its recommendations in 2016 and continues to recommend starting routine screening at 50.

Typically, these home stool blood tests are repeated every year for good results.

In a press release announcing the update, the ACS said there is an expectation that screening will be regularly performed in adults age 45-49 as it has been recommended for those aged 50 and older.

The vast majority of colorectal cancers are still found in older people, with almost 90 percent of all cases diagnosed in people over 50.

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"Think of it this way", Dwyer says, "if screening started at age 20, you'd have maximum benefit but also a huge burden".

For younger adults like Gale Fritsche, now 55, of Allentown, Pennsylvania, existing recommendations fell short.

In the United States, colorectal cancer is the second-leading cause of cancer-related deaths among cancers that affect both men and women, according to the US Centers for Disease Control and Prevention.

Doctors aren't sure why colorectal cancers are increasing in younger adults. Dwyer is a co-author of the Cancer paper and works collaboratively with the organization Fight Colorectal Cancer.

When an organization like the American Cancer Society changes its recommendations, insurance companies typically follow suit.

"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.

If this new guideline is adopted, lives will be saved. It is not only a search for early cancer; more often than not, Wender says, it detects pre-malignant, suspicious lesions, or polyps, which are removed during the procedure. Two of the three models showed a "modest" benefit with colonoscopy every 15 years starting at age 45, whereas the third did not.

Such risks include false-negative or false-positive results, as well as rare complications or feelings of anxiety with more invasive testing approaches, such as colonoscopy.

American Cancer Society recommends earlier colorectal cancer screening