The American Cancer Society made headlines across the nation recently when they published a new screening guideline for colorectal cancer. The big change from previous guidelines was that people of average risk for colon cancer should start screening at age 45 instead of age 50. Why the change? The scientists found that the number of cases of colon cancer among adults age 65 and older had declined since 2000, which they attributed to an emphasis on screening for colon cancer and better treatments if diagnosed. However, they noticed a 51% increase in diagnoses of colon cancer among adults age 55 or lower from 1994 to 2014, as well as an 11% increase in deaths from the disease from 2005 to 2015. Because of the number of younger people getting colon cancer before the first recommended screening at age 50, they analyzed the data further. Their models showed that by beginning screening at age 45, more early cancers would be detected. It would also be an efficient use of screening tools and time.
These screening guidelines are intended for people who are considered at average risk for colon cancer (for example, who have no family history of colon cancer or colon polyps, and have no symptoms). So, what if you’re concerned that you may have a higher than average risk, or you’re concerned about symptoms you’re experiencing? Then it’s time to make an office visit with your doctor. During that time, you will discuss your risk factors for colon cancer and your symptoms. Your doctor will then recommend a test for you if it’s needed. It’s important to follow your doctor’s advice.
In the meantime, there are some lifestyle things you can do to help prevent getting colon cancer. The American Cancer Society has found several lifestyle factors associated with Western culture that increase the risk of colon cancer: physical inactivity, obesity, cigarette smoking, drinking large amounts of alcohol, eating processed or red meat, not eating enough fruits and vegetables, and not getting enough fiber or calcium in the diet. In fact, one study estimated that 51% of cases of colorectal cancer in women and 58% in men were influenced by these lifestyle factors. That’s a lot!
In 2017, the three major societies for gastroenterology (American College of Gastroenterology, American Gastroenterological Association, and American Society of Gastrointestinal Endoscopy) put forth an updated recommendation that African Americans start screening at age 45 because of higher incidence of early colon cancer in this group. The new guideline from the American Cancer Society takes that recommendation one step further in its instruction that screening begin at age 45 for all individuals, earlier for those with higher risk. The three major American gastroenterological societies named above have sent emails to their members that they are studying the data collected by the American Cancer Society carefully, in order to revise their own guidelines in the future if needed.
So, what should patients do in the meantime, as experts seek to agree on the proper time to start screening for colon cancer?
- Know your body.
Look in the toilet after every bowel movement for bloody or black colored stools. This could signal a problem and should prompt a visit to your doctor regardless of your age.
- Know your family history.
Your family history is an important factor in determining when you should start screening for colorectal cancer and how often you should be screened.
- If in doubt, talk to your doctor.
It’s always best to talk to your doctor if you have questions or concerns about your health.
As the Colorectal Cancer Alliance’s mission statement reads, let’s look forward to “a world free of colorectal cancer” thanks to prevention.