JOHNSTOWN – Overall diagnoses and deaths associated with colon and rectal cancers continue to drop as more people avoid tobacco and get their recommended screenings from age 50 to 75.
But there’s been an alarming rise in colorectal cancers and deaths in younger adults, leading major health care groups to recommend earlier screenings.
Last month, the U.S. Preventive Services Task Force and the Centers for Disease Control and Prevention became the latest to recommend screenings begin at age 45 and continue until at least age 75.
“We are seeing it earlier more and more,” said Dr. Mayruathan Kesavan, a gastroenterologist with Conemaugh Physicians Group.
“The USPSTF recommends starting the screening process at age 45, so 45 is going to be the new 50,” he said.
The American Cancer Society and American College of Gastroenterology had already revised their guidelines to the younger age group, but the task force recommendation means insurance companies will be required to cover the screening tests.
Doctors say colonoscopy remains the gold standard for screening. The procedure involves feeding a camera-tipped, flexible tube through the rectum and into the colon to look for polyps or other symptoms.
The task force acknowledges that some patients are unable or unwilling to undergo colonoscopies. For them, there is a lab test that looks for blood in the stool.
Several other less-invasive screening options are available, but abnormal results on any of the other tests should be followed with a colonoscopy, anyway, the task force recommendations say.
No one should put off screening, Kesavan said.
“Colorectal cancer is preventable, treatable and curable if it’s caught early,” he said.
Some of the polyps found with screening are harmless, but some are known to lead to cancer.
“If you can identify the lesion early, you can prevent it from becoming cancer,” he said.
Colorectal cancer is the leading cause of cancer deaths in men 20-49 and the third-leading cause of cancer deaths in women for that age group.
Kesavan and other experts stress that not enough people in the 50-75 age group have been getting their screenings either. The task force notes that, despite strong evidence that screening is effective, about one in four of those eligible have never been screened.
“Far too many people in the U.S. are not receiving this lifesaving, preventive service,” task force Vice Chairman Dr. Michael Barry said. “We hope that this new recommendation to screen people ages 45 to 49, coupled with our long-standing recommendation to screen people 50 to 75, will prevent more people from dying from colorectal cancer.”
Some people put off screenings over the past year because of COVID-19 restrictions or fears. Kesavan said those people should come back to their doctors and get scheduled.
“I’m encouraging everyone not to wait too long,” he said. “Get your screening as soon as possible.”
Those squeamish about a colonoscopy should talk to their doctors about other options.
“Based on the evidence, there are many tests available that can effectively screen for colorectal cancer, and the right test is the one that gets done,” task force member Martha Kubik said. “To encourage screening and help patients select the best test for them, we urge primary care clinicians to talk about the pros and cons of the various recommended options with their patients.”