American Cancer Society advises colorectal screens at 45, not 50

Cancer Group Calls for Colorectal Cancer Screening Starting at Age 45

Cancer Group Calls for Colorectal Cancer Screening Starting at Age 45

The American Cancer Society has changed its colorectal cancer screening guidelines.

Dr. Thomas Weber, who is the co-chairman of an early-age onset colon cancer task group for the National Colorectal Cancer Roundtable but who was not involved in writing the new recommendation, called lowering the age for first screening "a game changer" that could save thousands of lives.

But the American Cancer Society this week changed its advice and is recommending that screening start five years earlier.

The organisation stated that the screening should begin at age 45, after a research recently conducted revealed that there was a 51 percent percent increase in colorectal cancer among people under 50 since 1994, and an accompanying rise in death rates.

Colorectal screening should now begin at age 45, rather than age 50. She's still hopeful that guidelines will continue to evolve and incorporate younger ages, particularly for high-risk groups.

Populations at high risk of colorectal cancer include African-Americans, Alaska Natives, Native Americans, and anyone with a family or personal history of rectal polyps. Prior recommendations to catch slow-moving malignancies advised the start of regular checks at age 50, but a paper published by the ACS Wednesday said Americans should jump on it sooner.

But the ACS is now changing that advice - a shift largely driven by the fact that colorectal cancers are increasingly being diagnosed in younger Americans.

"While the causes of this increase are not understood, it has been observed in all adult age groups below the age when screening has historically been offered, and is contributing significantly to the burden of suffering imposed by premature CRC mortality", the report says.


The researchers' new modeling study was an extension of analyses conducted for the US Preventive Services Task Force recommendations, and it assessed the potential risk and benefit of various colorectal screening strategies among black and white men and women in the United States.

"Someone born in 1990 has twice the chance of developing colorectal cancer than someone born in 1950", Wolf said. Clinical trials are the "gold standard" for proving that - and most trials of screening have not included people younger than 50.

The ACS recommends annual screening with a fecal immunochemical test or a high-sensitivity guaiac-based fecal occult blood test or every 3 years with a multitarget stool DNA test.

The models show that starting a colonoscopy earlier, at the age of 45, increased life-years by 6.2 percent compared to beginning at 50, as we do now. Rectal cancer has risen more rapidly, by 2 percent to 3 percent per year. As part of the review process, the USPSTF took into account three computer simulations that considered different starting ages and screening intervals. It used existing data to estimate the effects of screening at age 45.

"This is a very, very big deal", said Weber, who is director of surgical oncology for the northwest region of Northwell Health.

Yet "there are many ways you can screen for colon cancer beyond colonoscopy, and we can find a way no matter how squeamish people are", Azad said.

Learn about the symptoms of colorectal cancer from the American Cancer Society's website.

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