New Guidelines Advise Younger Age For First Colorectal Cancer Screening

Recent research has shown that colorectal cancer is affecting more and more younger people – so guidelines for screenings such as colonoscopy have changed.

The updated guidelines from the American Cancer Society, which have been adopted by the UH Digestive Health Institute, say colorectal cancer screening should begin at age 45 for all people at average risk. Previous guidelines suggested screening should start at 50 years of age and at age 45 in African-Americans. The hope is that even more lives will be saved with this revision.

Colorectal cancer is one of the most preventable forms of cancer.

Rise in Cancer Among Younger People

“University Hospitals is matching the new guidelines from the American Cancer Society for colorectal cancer screening because we recognize a significant number of men and women are being diagnosed with colorectal cancer before age 50,” says John Dumot, DO, Director of the UH Digestive Health Institute. “We have seen colorectal cancer develop in young patients and often they have no identifiable risk factors like family history of colorectal cancer.”

Adults born around 1990 have twice the risk of colon cancer and four times the risk of rectal cancer compared with adults born around 1950, who have the lowest risk, according to the American Cancer Society. Though the exact cause of this increased cancer prevalence among younger age groups is unknown, the American Cancer Society suggests poor diet and sedentary lifestyles may account for the disparity.

Colorectal cancer incidence has declined steadily over the past two decades in people age 55 and older because of screenings that result in the removal of precancerous polyps. But the rate of colorectal cancer has increased 51 percent among those younger than age 50 since 1994.

“Other forms of cancer testing like mammography look for evidence of disease but colonoscopies are the only ones that can actually prevent cancer because you are removing precancerous polyps,” says Greg Cooper, MD, Medical Director, GI Cancer Center of Excellence and Co-Program Leader, Cancer Prevention at UH.

One in three adults are not getting the recommended colon cancer screenings. Yet regular screenings can and do save lives.

Dr. Cooper says people wait for a variety of reasons, including fear.

“Even if people are able to overcome their embarrassment, often they have a fear of the unknown and the prep work they’ve heard about with a colonoscopy," he says. "If patients have concerns about the procedure, they have the option of scheduling a consultation with a specialist first.”

The American Cancer Society recommends:

• Adults age 45 and older with an average risk of colorectal cancer undergo regular screening with either a high-sensitivity stool-based test or a structural (visual) exam, depending on patient preference and test availability.
• As part of the screening process, all positive results on non-colonoscopy screening tests should promptly be followed up with a colonoscopy.
• Average-risk adults in good health with a life expectancy of greater than 10 years should continue colorectal cancer screening through age 75. Clinicians should individualize colorectal cancer screening decisions for individuals ages 76 through 85, based on patient preferences, life expectancy, health status and prior screening history. Clinicians should discourage individuals over age 85 from continuing colorectal cancer screening.

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The board-certified gastrointestinal physicians and surgeons at University Hospitals are leaders in screening, diagnosing, managing and treating all types of colon polyps, colon cancer and other gastrointestinal conditions. Learn more about colon cancer screening services at University Hospitals.