An influential panel is recommending screenings for colorectal cancer, the third leading cause of cancer deaths in the U.S., should begin at age 45 instead of 50, which is the current standard. The U.S. Preventative Services Task Force made this recommendation published May 18 in the journal JAMA stating that moving routine colorectal cancer screenings five years earlier could catch the disease earlier in those under 50 thus preventing more deaths among Americans. It is estimated that for the year 2021, almost 53,000 U.S. citizens will die from this disease.
This Task Force also recommended that physicians selectively offer screening to adults 76 to 85 years of age.
By changing the recommendation of beginning colorectal cancer screenings at age 50 to now 45, this would make 20 to 22 million Americans immediately eligible for screening. Unfortunately, this exceeds the colonoscopy capacity of U.S. healthcare providers. Many decisions will need to be made in order to create a balance of screening these newly eligible people while not removing resources from individuals over age 50 who are already at the highest risk of being diagnosed with colorectal cancer.
It has been recognized that people of color and those in underserved communities often have lower screening rates for colorectal cancer. With this new recommendation, it is meant to encourage, enlighten, and to capture these populations to seek out colorectal cancer screenings at an earlier age. Currently, black people are 20% more likely to be diagnosed with this disease than other racial groups and are almost 40% more likely to die from it. This new recommendation helps move insurers to cover the cost of colorectal screening for these populations removing any barriers preventing black people from seeking this procedure.
Another factor driving this decision is that since the early 2000s, the rates of colorectal cancer has been rising about 2% per year among people ages 45-49. Already about 1 in 10 people diagnosed with this type of cancer is under age 50.
Right now, individuals have options on how they want to be screened for colorectal cancer. Many would rather skip the more invasive colonoscopy and instead do an at-home test. There has been an increase in people choosing at-home screenings in the U.S. from 15% to 22% that resulted in more than 655,000 colorectal cancer screenings and a little more than 2700 colorectal cancer diagnoses. It is believed that people in their mid-forties will take advantage of the at-home screening tests. This is welcome news since during 2020 and the pandemic, there was a 90% reduction in colonoscopy screenings.
The decision by the task force was also based on the fact that people under the age of 50, may have symptoms of colon cancer such as bleeding, abdominal pain, and weight loss, but may assume they are too young to have this type of cancer.
In the meantime, any patient with questions on colorectal screening or help needed for selecting the best screening test for them, should discuss this with their primary care physician who can guide them in these decisions
