Americans urged to get colon cancer screening earlier

National

(AP/WOOD) — Americans should start getting screened for colon cancer earlier — at age 45 instead of waiting until they’re 50, according to guidelines released Tuesday.

The U.S. Preventive Services Task Force said it’s time for the change because colorectal cancer increasingly is appearing in younger adults.

That’s something Dr. Randall Meisner, a gastroenterologist with Spectrum Health in Grand Rapids, has noticed with his patients as well.  

“We’ve been really surprised at how many younger people, below the past screening age of 50, have come in with big polyps, growths, masses even seeing people in their early 40s come in sometimes in their 30s as well with symptoms that had been going on a long time and were eventually, finally referred for colonoscopy. These are things that we would have just attributed to hemorrhoids or other etiologies of rectal bleeding in the past,” said Meisner.

Colorectal cancer is one of the nation’s leading cancer killers, claiming about 50,000 lives a year. Overall, cases and deaths have inched down in recent years, thanks in part to screening tests that can spot tumors early — or even prevent them by removing precancerous growths.

Colorectal cancer is most common in older adults and the task force has long recommended that people ages 50 to 75 get screened. But the rate of new cases before age 50 has been rising since the early 2000s. So the new guidelines say adults at average risk of colorectal cancer should be screened from ages 45 to 75.

Meisner thinks this change has been a long time coming, and doctors should adjust how they respond to younger patients who show up with symptoms.

“If somebody has rectal bleeding, change in stools, abdominal pain or is losing weight, we don’t just want to attribute that to another etiology.  That patient’s going to need to be screened for colorectal cancer, even if they’re in their 30s versus usually we would sometimes say, ‘Oh, we can have rectal bleeding from hemorrhoids or a fissure or something else.’ We can’t do that anymore. I think those days are over,” he said.

Meisner also recommends that anyone with a family history of colorectal cancer go for a screening no later than 10 years prior to the age their family member was at diagnosis.

The decision, published in the Journal of the American Medical Association, means most insurance plans would have to cover the checks with no copay. The change brings the task force in line with the American Cancer Society, which lowered its recommended screening age to 45 in 2018.

The new advice shows “45 is the new 50 for this important cancer prevention screening intervention,” Dr. Kimmie Ng of the Dana Farber Cancer Institute, who wasn’t involved in the task force deliberations, wrote in JAMA.

How often people need to get checked depends on the type of screening they choose. There are a variety of options, including yearly stool-based tests or colonoscopies that may be done every 10 years.

But about 1 in 4 people between ages 50 and 75 have never been screened for the disease.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

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