The U.S. Preventive Services Task Force is now officially recommending getting screened for colorectal cancer at age 45, rather than 50.
Colorectal cancers are the third most common type of cancer in men and women and the second leading cause of cancer death in the United States for men and women combined. The American Cancer Society estimates that in 2021, about 149,000 will be diagnosed with colorectal cancer and that it will cause over 52,000 deaths.
Colorectal cancer screening saves lives. When detected early, colorectal cancer is treatable and can even be cured with surgery.
Washington University colon and rectal surgeon Sean Glasgow, MD, explains why the age was lowered and the significance of the new colorectal cancer screening guidelines.
Colorectal Cancer Screening Guidelines Explained
Why was the recommended age for getting screened for colorectal cancer lowered?
Dr. Glasgow: We are seeing increased incidence of colorectal cancer in young patients and by young women younger than age 50, and that’s why the Task Force examined the data and the evidence that was in the medical literature and decided to lower that recommended screening age to age 45.
Why has colorectal cancer increased among younger patients?
Dr. Glasgow: It’s really multifactorial. Diet is one factor, and a more sedentary lifestyle is another factor. But regardless of the reasons we are seeing it more frequently.
Are certain populations at higher risk for colorectal cancer?
Dr. Glasgow: African Americans have been at higher risk for colon cancer, so the screening age has always been a little bit younger for that population. Other societies like the American Cancer Society have recommended age 45 over the last several years. And now the U.S. Preventive Services Task Force agrees with that recommendation.
Are there any symptoms of colorectal cancer patients can look for?
Dr. Glasgow: These guidelines specifically are for asymptomatic individuals, and that’s how most colon cancer is detected if it is based on screening exams, either colonoscopy or stool studies or imaging. But some patients will have changes in their bowel movements, rectal bleeding, weight loss, or abdominal pain, and that should prompt some further investigation as well.
How does colorectal cancer screening work?
Dr. Glasgow: There are five screening tests for colorectal cancer. Talk with your doctor about which tests are right for you. The five screening tests are:
- Digital rectal exam: The doctor gently inserts a gloved, lubricated finger into the rectum and feels for abnormal areas.
- Fecal occult blood test: Samples of stool are tested for blood that is not visible to the eye. Blood can be a sign of polyps, other benign conditions or cancer.
- Sigmoidoscopy: The doctor inserts a small, flexible, lighted tube into the rectum and lower colon to inspect up to 25 inches of the lower bowel. Polyps can be easily removed during this exam.
- Colonoscopy: The doctor inspects the entire colon with an instrument similar to a sigmoidoscope, but longer. Any polyps or suspicious growths can be removed during this exam.
- Barium enema with air contrast examination: For this exam, barium sulfate, a chalky substance that shows up on X-rays, is given in enema form. X-rays are then taken of the colon. To make small tumors easier to see, the doctor may carefully pump in air to expand the colon.
High-risk patients should get screened regularly up until the age 75. After age 75 it really should be individualized with your physician and determining whether you need to continue screening.
Will colorectal cancer screening be covered by insurance companies?
Dr. Glasgow: That’s why this is so important. The U.S. Preventive Services Task Force affects who gets reimbursed, and insurance coverage for these screening tests. So by stating patients should get it starting at age 45, it is going to be covered. It’s federally mandated for coverage.
Where can I learn more about colorectal cancer screening?
Dr. Glasgow: Siteman Cancer Center has an online tool that helps patients assess their cancer risk and suggest ways to lower it. It’s available at YourDiseaseRisk.com.
To learn more about the Colorectal Cancer Screening Program at Siteman Cancer Center, please call 314-747-3046 or visit the Siteman Cancer Center website.
To make an appointment with a Washington University colorectal surgeon, please call 314-454-7177 or visit the Colon and Rectal Surgery website.