Colon Cancer Awareness: New Age Recommendation for Screening Could Save Lives

New science about colorectal cancer in younger people has spurred a national task force to expand its recommendation that all adults start getting colorectal cancer screenings at age 45, especially Black adults, who are more likely to die from the disease.

The U.S. Preventive Services Task Force updated its guidelines from about five years ago, when it recommended adults start screening for colorectal cancer at age 50.

Awareness that colorectal cancer can pose a risk to people under the age of 50 spiked this year after the death of actor Chadwick Boseman in August. Boseman, of “Black Panther” fame, was diagnosed in 2016 and died at age 43.

Colorectal cancer is the third-leading cause of cancer deaths in the United States. Despite strong evidence that screening for colorectal cancer is effective, about a quarter of people ages 50 to 75 have never been screened, according to Dr. Khalid Alam, a board-certified gastroenterologist with Lee Physician Group.

Dr. Alam says that lowering the test age should raise awareness among everyone that colorectal cancer screens can potentially prevent the disease in populations of all races and ethnicities.

“In the past decade, the rate of new colorectal cancer cases has been increasing in younger people,” Dr. Alam says. “A 2013 study published in the Journal of the National Cancer Institute found that millennials and Generation Xers have twice the incidence rates of colon cancer and four times the rate of rectal cancer than people born around 1950 and earlier.

“Screening earlier will help prevent more people from dying from colorectal cancer,” Dr. Alam says.

In 2018, only 68.8 percent of adults reported being current with colorectal cancer screening, according to the Centers for Disease Control and Prevention (CDC).

“It’s usually in their mid-50s, and with incidence increasing, that means that we’re missing opportunities to prevent the disease, and we’re missing opportunities to avert preventable deaths,” Dr. Alam says. “A screening colonoscopy can find precancerous polyps, which can be removed before they have a chance to grow larger and become cancerous.”

The new guidelines now align with the American Cancer Society recommendation that adults of average risk for colorectal cancer start regular screening at age 45, Dr. Alam notes.

Talk to Your Doctor

Dr. Alam says that you should consult your doctor about getting a colonoscopy at a younger age if you have a family history of cancer colon.

He adds the same is true if you’re at a higher risk for colon cancer because of underlying intestinal conditions like Crohn's disease or ulcerative colitis.

The likelihood of surviving colorectal cancer depends on how early it is detected, Dr. Alam says.

“If found early, in many cases colon cancer is curable,” he notes. “Fifty percent of people diagnosed with colon cancer at stages I or II have a five-year survival rate of 90 percent. At Stage III, that drops to 75 percent, and, at Stage IV, to 10 to 15 percent.” 

Dr. Valerie Dyke of the Colorectal Institute in Fort Myers says colonoscopies are essential because they look at the entire colon and can pinpoint tiny troublemakers. 

"What we are looking for are these tiny little guys, those are benign polyps. You wouldn’t know if you had them because they are very small and they don’t cause any symptoms," she says. "Colonoscopy actually prevents colon cancer. In fact almost all of the people who get colon cancer are people who are behind in their screening.

"Not doing your screening puts you at exceptionally high risk for colon cancer because you haven’t had the opportunity to have the polyps taken out."

Symptoms

Doctors say that common symptoms include rectal bleeding, unexplained weight loss or fatigue, cramping in the lower abdomen, and a change in bowel habits. Don’t ignore them. Make an appointment with your doctor for an evaluation.

The task force, an independent, volunteer panel of national experts in prevention and evidence-based medicine, works to improve the health of all Americans by making evidence-based recommendations about clinical preventive services such as screenings, counseling services, and preventive medications.

The task force’s draft recommendation statement, draft evidence review, and draft modeling report have been posted for public comment here.

To learn more about Dr. Khalid Alam and the specialists at the Lee Health gastroenterology department, visit here.