American Cancer Society lowers age recommendation for colon cancer screenings

Nora Nguyen
June 3, 2018

Doctors should discourage anyone over age 85 from screening, the cancer society said.

While rates have remained stable for blacks under 50 - a group whose rates have traditionally been higher than whites - they have increased for whites under 50. Those include African-Americans, Alaska Natives, and American Indians, the cancer society said.

The new guidelines lower the age from 50 to 45, following a rise in cases in younger people.

"Given that we are being told that only 2/3 of adults 50 to 74 are adherent [with screening recommendations], this raises questions about the potential effectiveness of screening younger patients, especially with uncertain insurance coverage", Hoffman said. It concluded that the data was mixed and that a younger starting age would provide only a "modest" benefit.

The guidelines regarding screening for the older group are a "strong recommendation", because of "the greater strength of the evidence and the judgment of the overall benefit", the cancer society said in its news release.

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The new guidelines also call for screening through age 85 rather than 75.

"The most common finding when you're screening is actually not cancer". Early detection can help prevent colon cancer from forming; it is up to 40% preventable.

Previous year colorectal cancer claimed more than 50,000 lives in the United States.

The colon is also known as the large intestine; the rectum is the part of the intestine that descends from the colon to the anus.

Colorectal cancer deaths are declining, but shocking disparities remain.

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The options for qualified colorectal screening are: fecal immunochemical test annually; high-sensitivity, guaiac-based fecal occult blood test annually; multitarget stool DNA test every three years; colonoscopy every 10 years; computed tomography colonography every five years; and flexible sigmoidoscopy every five years.

The updated guidelines include six test options, ranging from non-invasive to colonoscopies. The cancer organization believes that the underlying risk of the younger group is probably close to that of the older group. More than 50,000 will die this year.

The same tests are recommended by the U.S. Preventive Services Task Force, a panel that reviews evidence and issues advice for a variety of screenings and treatments.

Experts say it is unclear why colon cancer rates are on the rise in younger people.

Andrea Cercek, an oncologist at Memorial Sloan Kettering Cancer Center in NY, said the updated guidelines may "capture a population at risk". "That's the public health statement, which is, pay attention to your bowels, and seek medical care if things don't seem right, if there's blood in your stools or your bowel habits change suddenly".

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