In a new guideline from the U.S. Preventive Services Task Force, researchers have recommended that individuals of average risk for the disease begin screening exams at 45 years of age instead of the traditional 50.
The team updated its 2016 recommendations and aligns them with those of the American Cancer Society, which lowered the age for initiation of screening to 45 years in 2018.
Colorectal cancer (CRC) is one of the most preventable malignancies, owing to its long natural history of progression and the availability of screening tests that can intercept and detect the disease early.
The overall incidence of CRC in individuals 50 years of age and older has declined steadily since the mid-1980s, largely because of increased screening and changing patterns of modifiable risk factors.
In the guideline, the team says lowering the recommended age to initiate screening will make colorectal cancer screening available to millions of more people in the United States.
Hopefully, many more lives will be saved by catching colorectal cancer earlier, as well as by preventing colorectal cancer.
American health insurance groups are required to cover, at no charge to the patient, any service that the USPSTF recommends with a grade A or B level of evidence, regardless of how much it costs.
The task force recommendation means that insurers will be required to cover preventive procedures such as colonoscopies and stool tests designed to detect colon cancer in the early stages.
The task force selected age 45 based on research showing that initiating screening at that age averted more early deaths than starting at age 50, with a relatively small increase in the number of colonoscopy complications.
There is no change to the USPSTF 2016 recommendation to only selectively screen individuals aged 76 to 85, as research shows only small increases in life-years gained.
While the majority of young-onset CRC diagnoses and deaths occurs in persons 45 to 49, the rate of increase in young-onset CRC is actually steepest in the very youngest patients.
Colon cancer incidence is increasing by 2% per year in 20 to 29-year-olds, compared with 1.3% in 40 to 49-year-olds.
Rectal cancer incidence is increasing by 3.2% per year in 20 to 29-year-olds and 30 to 39-year-olds, versus 2.3% in 40 to 49-year-olds.
Ultimately, optimal prevention and early detection of CRC in people younger than 45 will require further research into the underlying causes and risk factors of young-onset CRC, which have thus far remained elusive.
If you care about colon cancer, please read studies showing a gut feeling may be key to early detection of colon cancer and findings of this diet linked to high colon cancer risk.
For more information about colon cancer prevention and treatment, please see recent studies about new imaging tech could detect colon cancer with 100% accuracy and results showing that aspirin may stop colon cancer growth and recurrence.
The study is published in JAMA. One author of the study is Kimmie Ng, MD, MPH.
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