University Hospitals Digestive Health Institute Changes Colorectal Cancer Screening Guideline to 45 Years of Age

Update follows recent news from the American Cancer Society about disease increase in young and middle aged populations

CLEVELAND – Colorectal cancer is one of the most preventable forms of cancer and guidelines adopted by University Hospitals Digestive Health Institute and recommended by the American Cancer Society hope to save even more lives with the revisions. The updated guidelines 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.

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

According to the American Cancer Society, 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.

Colorectal cancer incidence has declined steadily over the past two decades in people 55 and over, due to screening programs that results in the removal of precancerous polyps. But there has been a 51 percent increase in colorectal cancer among those under age 50 since 1994.

Greg Cooper, MD, Medical Director, GI Cancer Center of Excellence and Co-Program Leader, Cancer Prevention at UH says, “If patients are getting less invasive tests they may not be as accurate and thus have to be done more frequently. 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.”

Currently 1 in 3 adults are not getting the recommended colon cancer screenings. But regular screenings can and do save lives. 

Dr. Cooper say 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. 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 ages 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 a part of the screening process, all positive results on non-colonoscopy screening tests should be followed up with timely 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.

About University Hospitals / Cleveland, Ohio
Founded in 1866, University Hospitals serves the needs of patients through an integrated network of 18 hospitals, more than 50 health centers and outpatient facilities, and 200 physician offices in 16 counties throughout northern Ohio. The system’s flagship academic medical center, University Hospitals Cleveland Medical Center, located in Cleveland’s University Circle, is affiliated with Case Western Reserve University School of Medicine. The main campus also includes University Hospitals Rainbow Babies & Children's Hospital, ranked among the top children’s hospitals in the nation; University Hospitals MacDonald Women's Hospital, Ohio's only hospital for women; University Hospitals Harrington Heart & Vascular Institute, a high-volume national referral center for complex cardiovascular procedures; and University Hospitals Seidman Cancer Center, part of the NCI-designated Case Comprehensive Cancer Center. UH is home to some of the most prestigious clinical and research programs in the nation, including cancer, pediatrics, women's health, orthopedics, radiology, neuroscience, cardiology and cardiovascular surgery, digestive health, transplantation and urology. UH Cleveland Medical Center is perennially among the highest performers in national ranking surveys, including “America’s Best Hospitals” from U.S. News & World Report. UH is also home to Harrington Discovery Institute at University Hospitals – part of The Harrington Project for Discovery & Development. UH is one of the largest employers in Northeast Ohio with 28,000 physicians and employees. 

Advancing the Science of Health and the Art of Compassion is UH’s vision for benefitting its patients into the future, and the organization’s unwavering mission is To Heal. To Teach. To Discover. Follow UH on Facebook @UniversityHospitals and Twitter @UHhospitals. For more information, visit UHhospitals.org.