45 is the New 50 for Colorectal Cancer Screening
The U.S. Preventative Services Task Force (USPSTF) recommends that people begin colorectal cancer screening at age 45, rather than 50, which was the previous recommendation. The updated guidelines consider the benefits of early detection and treatment for adults with no personal history or increased risk of the disease. Meera Yogarajah, MD, at the Cancer Center at Robert Wood Johnson University Hospital Hamilton (RWJUH Hamilton), an RWJBarnabas Health facility, in partnership with Rutgers Cancer Institute of New Jersey, New Jersey’s only National Cancer Institute -Designated Comprehensive Cancer Center, shares more about this change and why it is important.
Why did the recommendation change?
Research shows a recent increase in colorectal cancer occurring in younger adults. These cancers may be associated with poorer outcomes, as they are diagnosed later. In response to this trend, the USPSTF, an independent volunteer group of experts in prevention and evidence-based medicine, reviewed new data and concluded that screening for colorectal cancer in adults who are 45 to 49 years old can be helpful in preventing more people from dying of colorectal cancer.
What does colorectal cancer screening entail?
Colorectal cancer screening is used to detect cancer and remove precancerous polyps. There are several types of colorectal cancer screening methods. In colonoscopy, the rectum and entire colon are examined using a colonoscope, a flexible lighted tube with a lens for viewing and a tool for removing tissue. If your doctor finds polyps, they are removed and sent to a lab for further testing. Most patients receive some form of sedation during the test. The advantage of colonoscopy is removal of benign polyps will prevent these growths from turning into a cancer.
In sigmoidoscopy, the rectum and sigmoid colon are examined using a sigmoidoscope, a flexible lighted tube with a lens for viewing and a tool for removing tissue. During sigmoidoscopy, abnormal growths in the rectum and sigmoid colon can be removed for analysis (biopsied). People are usually not sedated for this test. However, only the last 20 percent of the colon is examined.
Both polyps and colorectal cancers can bleed, and stool tests check for tiny amounts of blood in feces (stool) that cannot be seen visually. With these tests, stool samples are collected by the patient using a kit, and the samples are returned to the doctor. People who have a positive finding with these tests will need to have a colonoscopy. Additionally, some newer stool tests rely on detection of DNA from tumors in the stool sample, increasing the accuracy beyond using detection of trace blood alone.
Why is it important to follow these guidelines?
According to the American Cancer Society in 2024, an estimated 106,590 cases of colon cancer and 46,220 cases of rectal cancer will be diagnosed in the US, and a total of 53,010 people will die from these cancers. Colorectal cancer is the second leading cause of cancer death in the nation. Colorectal cancer usually does not cause any symptoms until it is advanced and starts to spread through the body. Most colorectal cancers can be prevented through screening and testing at regular intervals, leading to detection and removal of polyps. Colorectal cancer is largely preventable. This is why it is extremely important to follow the recommended guidelines and get an initial screening at 45 years of age for those at average risk or earlier for those at higher risk.
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