Monday, 17 December, 2018

American Cancer Society: Colorectal cancer screening should start at age 45

Colon cancer screening should begin at 45-American Cancer Society Colorectal cancer screenings should start at 45, new guidelines say
Johnnie Parks | 02 June, 2018, 03:30

The new guideline puts the American Cancer Society at odds with other national organizations that recommend starting screening at 50 and raises questions about whether health insurers will pay for the earlier tests. "Therefore, what we've observed with the rising incidence is not simply a result of detection bias", Chang said. A 2014 study, of which he was the senior author, showed that by 2030, based on current trends, rates for colon and rectal cancers will increase by 90 percent and 124 percent, respectively, for patients 20 to 34 years old.

"Incorporating this epidemiological shift into contemporary modeling of CRC screening demonstrated that the benefit-burden balance is improved by lowering the age to initiate CRC screening to 45 years".

The younger starting age is a "qualified recommendation", because of limited data on the risks and benefits of screening in people ages 45 to 49, as most studies of colorectal cancer screening were limited to patients ages ≥ 50. Rich Wender. "The best test is the test that gets done".

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.

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.

"Someone born in 1990 has twice the chance of developing colorectal cancer than someone born in 1950", Wolf said. It also categorized tests for the 45-50 age group as a "qualified recommendation" and tests for those over 50 as a "strong recommendation".

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.

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Colon cancer is the second leading cause of cancer-related deaths behind lung cancer.

The most common screening method is a colonoscopy exam that snakes a tiny camera through the rectum to view the colon to search for abnormal tissue growth. "Whether it's 45 or 50, the most important thing is for people to get screened and keep screening". Colorectal cancer can be treated if detected in its early stages. By 2030, 10.9 percent of all colon cancers and 22.9 percent of all rectal cancers will be diagnosed in patients younger than age 50. Historically, African-Americans, Native Americans and Native Alaskans have had higher rates of these types of cancer.

The new recommendation is for people at average risk, those who do not have a history of colon or rectal polyps. Based on microsimulation modeling that showed a favorable risk:benefit ratio for screening at age 45, the recommendation comes with the "expectation that screening will perform similarly in adults ages 45 to 49 as it does in adults for whom screening is now recommended".

"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.

Consuming red meat, processed meat and alcoholic beverages, among other factors, could increase the risk of colorectal cancer.
"We would like to see it (guidelines) be even lower, but this is a victory for sure".

Most colon cancer occurs in adults 55 and older, and the good news is that rates of cases and deaths have been falling for decades.

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

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