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12 November, 2020

Make That 45, Not 50 – to Start Your Colorectal Screening

The U.S Preventative Services Task Force joins the American Cancer Society and other groups in suggesting that individuals begin colorectal cancer screening at age 45 instead of 50.

Every year there are thousands of preventable deaths from colorectal cancer. Colorectal cancer, which comprises both colon and rectal cancer, is the third leading cause of cancer-related deaths among American men and women, with approximately 53,200 people expected to die from the disease by the end of 2020 (American Cancer Society). And while the overall death rate has been dropping over the last few decades, thanks to advanced screening methods and increased awareness, deaths among people younger than age 55 have been steadily increasing 1% per year since 2007. By the end of this year, the American Cancer Society estimates that 17,930 new cases of colorectal cancer and 3,640 deaths from the disease will be in individuals younger than 50.

Regular screenings help prevent these deaths by catching the disease in its early stages, when it is most treatable. According to the American Cancer Society (ACS), if colorectal cancer is detected in stage I, the average 5-year survival rate is over 90%.

The American Cancer Society Changed Their Guidelines First

The American Cancer Society first updated its guidelines to reduce the initial screening age from 50 to 45 two years ago, after analyzing data from a major study which showed that new cases of colorectal cancer have been occurring at an increasing rate among younger adults. The ACS recommends that those at average risk for colorectal cancer begin regular screenings at age 45. Individuals at an increased risk (like those with a family history of colorectal cancer or certain inflammatory bowel disease) may need to begin screening even earlier, or screen more frequently, depending on their physician’s recommendation.

The USPSTF

The U.S. Preventative Services Task Force (USPSTF) is a panel of national experts in prevention and medicine. Their mission is to improve the health of Americans by making evidence-based recommendations about clinical preventative services such as screenings and preventative medications. Their recommendations carry significant weight, as most insurance companies follow their guidance and regulate their coverage accordingly.

This most recent suggestion follows building evidence of an increase in colorectal cancer among younger adults as well as mounting pressure from various public health and patient advocacy groups to lower the starting age.

In conducting their research, the Task Force confirmed that additional deaths from colorectal cancer could indeed be prevented by starting screening at age 45 instead of 50. While the difference in recommendations between the ACS and the USPSTF has caused confusion for physicians, and has made it difficult for patients under the age of 50 to get insurance coverage for colorectal screenings, at this time, the recommendation is not final.

If you are concerned about colorectal cancer or have questions about a screening, regardless of your age, please have a conversation with your physician.

12 November, 2020

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