The American Cancer Society on Wednesday recommended most adults should start colon cancer screenings at age 45, a move that reduces the recommended age from 50, which a government advisory group issued two years ago.
Here are 7 things to know in the wake of this news.
Colorectal cancer (CRC) is the second-leading cause of cancer death in the U.S. This new recommendation has been featured so prominently in the news media in part because this type of cancer affects so many people. The American Cancer Society says 140,000 people will be diagnosed with CRC this year and 50,000 people will die from it.
CRC is increasingly affecting younger people. The American Cancer Society says that incidences of CRC in adults younger than 55 have increased by approximately 50 percent since the mid 1990s, with a more than 10 percent increase in mortality from 2005 to 2017. Clearly something is going on in our society that CRC is affecting more and younger people than it used to. It may be diet, obesity, or lack of exercise. Whatever the cause, I think this is a key reason why the American Cancer Society made its recent recommendation, which differs from U.S. Preventive Services Task Force’s 2016 recommendation of CRC screenings at age 50.
Catching CRC early can boost a patient’s chances of survival. CRC rates have declined in people over 55, and a big reason is because of screenings. There are at least two reasons for this: 1. CRC screening with colonoscopy actually prevents cancer by removing polyps which would otherwise become cancer; and 2. CRC can be better treated if it’s caught in its early stages.
People in a high-risk category may need screening even younger. Some families have a history of CRC or a condition related to their digestive system. Some of those folks will need screening even before age 45. Your primary care doctor can help you navigate your best options and the timing for each.
A screening doesn’t have to be a colonoscopy. A colonoscopy involves taking a day off of work to undergo the procedure. Also, a family member or friend has to be available to drive you home due to lingering effects of sedation. Plus, there’s also the unpleasant preparation of drinking a large container of fluid over several hours the previous evening to wash out the bowel. Yes, it’s a lot of work, and we want people to undergo this procedure when recommended by their primary care doctor. But there are other ways to get screened. Other options include an at-home stool test that checks for blood, as well as different types of X-ray tests such as CT colonography. Your primary care physician can offer suggestions on what might be best for you. Really, any screening at first is a good screening. Too many people don’t take advantage of what a screening can offer.
Screenings are great…but not perfect. It’s rare, but a basic screening can sometimes deliver a false positive, which can lead to a more invasive procedure. Also, a colonoscopy can sometimes — again, it’s very rare — cause complications, which might require surgery to repair. Overall, however, today’s best healthcare practices for screening offer an excellent chance to safely find out if you could be developing cancer. For the sake of your health, I would rather you take the extremely high odds of a screening going well instead of forgoing a screening altogether.
You can reduce your chances of developing cancer. No matter when you choose to start colon cancer screenings — and I hope you do — it’s important to live in a way that reduces your chances of developing cancer. Yes, some people are more genetically pre-disposed to developing cancer, but many studies have shown a link between cancer and lifestyle choices. You can reduce your chances of developing all cancers by eating a healthy diet, getting regular exercise, managing stress, and maintaining healthy relationships and a balanced lifestyle. We want you to be around for your family and friends for as long as possible.
So if you are over 45, and you have not had a colonoscopy in the last 10 years, or a stool test in the last year, make an appointment with your doctor and get screened. It could save your life so that you can be there for your children and grandchildren.
To schedule a screening, contact your primary care provider or a provider at Loma Linda University Health at 909-558-6600 or visit the website https://lluh.org/primary-care.
—Mark Reeves, MD, PhD, is director of the Loma Linda University Cancer Center.