Monday, 18 June, 2018

Colorectal cancer start screening age changed

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Marlene Weaver | 02 June, 2018, 03:30

If you're in your mid-40s and haven't had your colon checked, it might be time.

Screenings should begin at age 45, according to new guidelines the American Cancer Society released Wednesday.

Cancer experts have noted a rise in stories like Lari's: colorectal cancer in younger and younger patients.

Those at higher risk include African Americans, Alaska Natives, and people with a family history or a personal history of colon or rectal polyps; risk factors such as these could require screening earlier. In its new recommendations, the cancer society recommends choosing from one of six screening tests, which are also now recommended by other expert groups. They now recommend routine screening begin at age 45 rather than age 50.

Over 140,000 Americans are expected to be given a diagnosis of colon or rectal cancer this year.

With colon cancer being the second leading cause of death in the US, the American Cancer Society is now advising that you get your colonoscopies sooner.

The new recommendations apply to people at average risk for colon and rectal cancer.

While few trials have looked at screening 45-year-olds, new statistical models reviewed by the cancer society showed that the younger group should benefit almost as much as slightly older adults do, Wolf said.

If you're in your mid-40's and haven't had your colon checked, it might be time. "And we don't really know why". There were no other changes made to other screening tests.

The guidelines also call for some people to continue screenings through age 85 instead of 75. The change is based on new predictive modeling studies that were done using updated estimates for the CRC risk in the young.

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The ACS recommends annual screening with a fecal immunochemical test or a high-sensitivity guaiac-based fecal occult blood test or every 3 years with a multitarget stool DNA test.

A colonoscopy is not the only effective screening tool.

"Consumers should also understand that there are many screening options, and they may find certain screening options more affordable than others, particularly when faced with potential out-of-pocket expenses", the statement said.

The recommendation appears online in CA: A Cancer Journal for Clinicians. "The best colorectal screening test is the one that gets done".

That means that "we hope that doctors will look at this and at least start discussions of colorectal cancer screening with their 45-year-old patients", Wolf said. "The evidence is now absolutely clear, and I can't emphasize how carefully this was done". As a result, testing could be offered earlier or more often in groups of people at risk (risk-adapted screening). "But those things do not fully explain the rise".

"I'm very excited about it", said Georges, from Fort Wayne. Clinical trials are the "gold standard" for proving that - and most trials of screening have not included people younger than 50.

Breedlove said she's heartened by the change but believes the guideline should go even lower. "There is excellent evidence that we are doing the right thing".

If this new guideline is adopted, lives will be saved.

Weinstein said, though, that data show the colorectal cancer rate in patients under age 50 has increased 51 percent since 1994. Two of the three models showed a "modest" benefit with colonoscopy every 15 years starting at age 45, whereas the third did not.

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