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Colon cancer screenings at 45? New guidelines say yes

By Leah Groth ; Updated May 31, 2018

If you are nearing your mid-40s, you might want to think about getting your colon checked. The American Cancer Society (ACS) has updated its guidelines for colon and rectal cancer screening, recommending that adults should get screened at 45 instead of 50.

According to Andrew Wolf, associate professor of medicine at the University of Virginia, who led the group in writing the new recommendations, this shift was inspired by the findings of a 2017 study showing a rise in colon and rectal cancer among millennials and Generation X adults.

While colorectal cancer rates were found to have fallen overall due to an increase in screening with older adults, it wasn’t the case with young adults. In fact, according to the American Cancer Society, since 1994, colon and rectal cancers have increased a staggering 51 percent among adults under the age of 50, something Wolf explains may have to do with obesity and poor diet.

“Behind these numbers are real people and real faces, and all of us in the colorectal cancer world and all the gastroenterologists and all the oncologists have been seeing more and more young people who develop this disease,” explained Dr. Richard Wender, chief cancer control officer at the American Cancer Society, who oversaw the development of the new guidelines.

“In people born more recently, they’re at four times the risk for rectal cancer than people born in the 1950s (at the same age), for example, and double the risk of colon cancer,” he said. “It’s what we call a birth cohort effect. Nobody knows why really clearly, and that’s a big area of interest, but nobody’s questioning that it’s happening.”

Colorectal cancer is the fourth most common cancer diagnosed in adults and the second leading cause of death from cancer, with an estimated 50,000 deaths annually. The disease impacts various racial groups, but the highest incidents and mortality rates are with African-Americans, American Indians and Alaska Natives.

While a colonoscopy is the most common testing tool for it, the updated guidelines also mention there are five other test options, including noninvasive stool samples. In their guidelines, the researchers offered specific strategies for screening: undergoing a colonoscopy every 10 years; a “virtual colonoscopy” and flexible sigmoidoscopy (a procedure in which a flexible, narrow tube with a light and tiny camera on one end is used to look inside the colon) every five years; a multitarget stool DNA test (a non-invasive stool test) every three years; a take-home fecal immunochemical test (another noninvasive stool test that can be conducted at home); or a high-sensitivity guaiac fecal occult blood test (another fecal test which detects invisible blood) annually.

However, they do mention that getting screened — whichever option you choose — is better than opting out. “We know from trials that if you offer a choice between colonoscopy and a less-invasive test, that more people will opt to be screened, which is our goal in the end,” he said. “The evidence is now absolutely clear, and I can’t emphasize how carefully this was done. It took us two years of work to provide a compelling argument and evidence that the screening age for everyone should begin at age 45, not age 50.”

If you are concerned about colon or rectal cancer, you should contact your doctor to talk about options. To learn more about the 10 signs and symptoms of colon cancer, click here.

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