New Research Shows Colorectal Cancer Screening Should Start At 45 Not 50

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New Research Shows Colorectal Cancer Screening Should Start At 45 Not 50
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Back in 2016, the US Preventive Services Task Force published a study whose results recommended that screening for colorectal cancer start at age 50 and should be continued for the next 25 years, until the age of 75. This recommendation has been used by the National Institutes of Health’s National Cancer Institute since then; the age group presented in the study receiving the most benefit from early screening, the study had showed. Colorectal cancer screening focused on the detection of adenomatous polyps and/or advanced adenomas, which are hallmarks of a colorectal cancer diagnosis. However, this data has changed with a new study, reported not two years later. [1]

Recent Data Demands Earlier Screening

While you think that moving the age group lower by five years isn’t such a big deal, think again. When a person’s lifespan and quality of life is affected by how early he or she is diagnosed, every day counts. At the United European Gastroenterology (UEG) Week last year in Barcelona, researchers from France revealed that colorectal cancer, while statistics were now lower among those aged 50 and older, was increasing among younger adults. Out of 6,027 colonoscopies conducted that were included in the study, the researchers found a 400 percent increase in neoplasia detection in the 45 to 49 age group compared to the 40 to 44 age group. Compared to the age group between 50 and 54, there was an 8 percent increase in the younger age group. [2]

Other statistics revealed in the study are as follows:

• Mean number of polyps and adenoma detection rate increased by 95.8 and 95.4 percent between the 45 to 49 and 50 to 54 age groups.

• The increased between 45 to 49 and 50 to 54 age groups was lower, at 19.1 and 11.5 percent respectively.

The lead researcher of this study, Dr. David Karsenti, presented these findings with the hope of helping more people improve their chances of surviving colorectal cancer with earlier detection. With colorectal cancer being the second most common cause of cancer-related mortality in Europe, the results of Dr. Karsenti’s study will help thousands, not just in Europe. The evidence that earlier screening reduces mortality rates still stands, and that’s why their research is so important. The earlier adenomas (which could be benign now but turn cancerous in the future) are removed, the better the chances a person has of surviving colorectal cancer. Early detection, in this case, is now early cancer prevention.

Know Your Risk Factors

Normal, healthy adults without personal or family history of colorectal cancer, should start screening at age 45, and not a day later. However, if you have other risk factors, screening should be done earlier. Major risk factors cited by the National Cancer Institute include family history of colorectal cancer, excessive alcohol intake, obesity, sedentary lifestyle, cigarette smoking, and unhealthy dietary habits. To add to that, if you have a personal history of IBD or inflammatory bowel disease (like ulcerative colitis or Crohn disease), you have an even higher risk than those without it. If your family has a history of adenomatous polyps, your risk also gets higher. [3]

Get Tested, Fight CRC

Here are few screening tests your physician may recommend to you:

Fecal occult blood tests (FOBT) show if you have blood in your stool that cannot be seen with the naked eye; blood in the stool can mean that you have a polyp that is bleeding (or it can mean you have a bleeding hemorrhoid, which in this case, is a lot better than being diagnosed with CRC). There are different kinds of FOBT, like Guaiac and FIT, so ask your physician which one would be better for you.

Stool DNA is the only stool DNA test that is FDA-approved, very similar to FIT FOBT, but detects DNA biomarkers for CRC in stool aside from blood.

Sigmoidoscopy involves the use of a flexible tube that is used to view inside your sigmoid colon and can also remove tissue to take samples. Other research has shown that regular sigmoidoscopy screening leads to 60 to 70 percent lower mortality of CRC among people aged 50 years and older.

Standard colonoscopy is basically the same as a sigmoidoscopy but involves viewing the entire colon instead of just the sigmoid. Similarly, this test can also take samples for biopsies.

Get screened!


[1] US Preventive Services Task Force, et al. (2017). Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement.

[2] Karsenti, D. et al. (2017). Adenoma detection rate according to age: colonoscopy screening should start at 45 years old. Presented at the 25th UEG Week Barcelona, October 30, 2017.

[3] National Cancer Institute. Tests to Detect Colorectal Cancer and Polyps.

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By Mike Westerdal CPT

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