New guideline: Screen for colorectal cancer at 45

Deaths growing among people younger than 50

Doctors may begin recommending their patients start screening for colorectal cancer at an earlier age.

The U.S. Preventive Services Task Force, a volunteer panel of national experts in prevention medicine, issued a statement that recommends screening should begin at 45 years old, instead of 50, as previous guidelines stated.

“We hope that this recommendation to screen people ages 45 to 74 for colorectal cancer will encourage more screening and reduce people’s risk of dying from the disease,” said task force chair Dr. Alex Krist, professor of family medicine and population health at Virginia Commonwealth University.

The American Cancer Society recommended earlier screening about two years ago based on computer simulations; however, experts say input from the USPSTF carries a lot of weigh.

Dr. John Kisiel, a gastroenterologist and associate professor of medicine at the Mayo Clinic, said most employerbased health insurers and Center for Medicaid & Medicare Services base coverage on these recommendations.

These insurers don’t cover screenings before the age of 50 for patients with no symptoms or family history, but Kisiel expects that to change soon.

“They will ultimately have to,” he said. “There are patients who are very interested in getting screened. I’m 46 and I would like to get screened.”

While deaths from colon and rectal cancers have been declining for decades due to improved screening and treatment measures, deaths among young people have been increasing slightly in recent years, according to researchers.

Colorectal cancer – which includes colon and rectal cancer – is expected to cause more than 50,000 deaths in 2020, including 3,640 deaths in people younger than 50, according to ACS.

About 30% of colorectal cancer diagnosed today is in people under the age of 55, said Dr. Nilofer Azad, an associate professor of oncology at Johns Hopkins Medicine.

“We are seeing more people in their 30s and 40s who are developing colorectal cancers, often because they’re having symptoms that aren’t thought to be cancers,” she said.

The updated recommendations come a few months after “Black Panther” star Chadwick Boseman died in August at the age of 43 after battling colon cancer since a 2016 diagnosis.

“New science about colorectal cancer in younger people has enabled us to expand our recommendation to screen all adults starting at age 45, especially

“We are seeing more people in their 30s and 40s who are developing colorectal cancers ...” Dr. Nilofer Azad Associate professor of oncology at Johns Hopkins Medicine

“The decision to start screening patients (earlier) is a step in the right direction.” Dr. John Kisiel Gastroenterologist and associate professor of medicine at the Mayo Clinic

Black adults who are more likely to die from this disease,” said Task Force member Dr. Michael Barry, professor of medicine at Harvard Medical School and clinician at Massachusetts General Hospital.

The task force recommends two types of tests to screen for colorectal cancer: direct visualization tests and stool-based tests. Symptoms of colorectal cancer include a change in bowel movements, rectal bleeding, blood in the stool and abdominal pain.

Some critics may say screening at an earlier age won’t prevent many cases of cancer, Kisiel said, and resources should be focused on older populations where more cancer can be found and screening compliance continues to be suboptimal.

But he believes doctors don’t have to make a choice between one population or another: It’s possible to start screening at an earlier age and focus on older patients at the same time.

“Cancers in patients under the age of 50 is something we see in our clinical practice every day,” Kisiel said. “The decision to start screening patients (earlier) is a step in the right direction.”