According to experts, colon cancer screening should start at age 45

Colorectal cancer Third major cause of cancer-related death In the United States, 53,200 Americans, women and men, are expected to die of colon or rectal cancer this year.

In the last 20 years Diagnosis of colorectal cancer According to the American Cancer Society (ACS), it is declining among people over the age of 65.

However, the proportion of new diagnoses is rising in the younger age group. It is estimated that 12% of cases of colorectal cancer diagnosed this year are people under the age of 50.

“Given the surprising increase in the incidence of colorectal cancer in people under the age of 50 in recent years, it may save lives by starting screening at an earlier age, along with other supporting data. Is expensive. ” Dr. Divya Mallam, Gastroenterologist at Torrance Memorial Medical Center.

Proposal by the US Preventive Medicine Committee Recommendations It still needs to be finalized and public comments are open until November 23rd.

During the final review of the guidelines, about five years ago, the Task Force was stuck at the age of 50 due to the start of regular screening. Dr. Folasade P. May, UCLA’s gastroenterologists and researchers have found something surprising at the time.

“All the modeling data they use clearly showed that starting screening at the age of 45 would save more lives,” she said.

The final Task Force review also contrasted with ACS. Updated guidelines In 2018, it states that regular screening should start at age 45.

While some physicians followed ACS guidelines, updating the Task Force recommendations will ensure that most health insurance plans cover screening costs.

The Task Force assigns letter grades to its recommendations and requires a private insurance plan to cover the full cost of the service receiving either “A” or “B” grades, with no out-of-pocket costs to the patient.

A “B” was added to the colonic rectal screening for people aged 45-49 years. This means that the patient has a moderate or high certainty benefit. Screening for people between the ages of 50 and 75 received an “A” grade.

For people over the age of 75, the Task Force recommends that patients consult their doctor about the risks and benefits of screening.

In May, it is estimated that an additional 21 million Americans will be screened for colorectal cancer if new recommendations are finalized.

Screening for younger ages also helps groups that are disproportionately affected by colorectal cancer.

“We believe this helps blacks, especially young blacks with early colon cancer,” May said.

According to the report, black Americans have the highest incidence of colorectal cancer. Centers for Disease Control and Prevention (CDC) — 40.4 percent compared to 36.3 percent for whites. Blacks are also more likely to die of colorectal cancer.

“Looking at the early-onset group (young people in this condition), blacks are the most affected,” May said.

By updating the screening guidelines, more cases of colorectal cancer can be detected early, but if easy to treat, the changes will still pose challenges, Mei said.

“We were already not good at it [colorectal cancer] Screening in the United States, “she said. “So, as a public health person who is also a doctor, I’m worried about how we screen millions of people.”

2018, 68.8 percent of Americans According to the CDC, people between the ages of 50 and 75 were screened for colorectal cancer.

May believes that shifting the focus to younger adults can have the unintended consequence of diverting medical resources over the age of 50. This can have a greater impact on some groups than on others.

“In doing so, we could in fact exacerbate some of the health inequalities found in older African-Americans, Latino-Americans, Asians, and Native Americans who already have low screening rates. “May said.

People with private health insurance can be screened for free, but millions of Americans are still Uninsured or uninsured Even under the Affordable Care Act (ACA).

These people who have to pay from their pockets for colonic rectal screening have a lot Lower screening rate..

The fate of the ACA is also balanced, and Republicans continue to push for its abolition and the US Supreme Court. Listen to the discussion About legality from November 10th.

May says that what is needed in the future is a real public health strategy to ensure that everyone targeted for colonic rectal screening is actually screened.

“We were able to make recommendations all day long, but if we don’t have a clear plan on how to offer this service to people, we don’t know how useful those recommendations are,” she says. I did.

Recent technological advances may also help improve the screening capabilities of healthcare systems and alleviate people’s anxiety about screening.

“Some people avoid screening for colorectal cancer until it’s too late to develop cancer. They are worried about having a colonoscopy and that there are other screening options available. Because I don’t know. “

these option Includes stool examination and virtual colonoscopy using CT scan. Although these procedures are less invasive, they should be performed more frequently than colonoscopy, which should be performed every 10 years.

People should also be aware of signs of colorectal cancer such as blood in the stool, rectal pain, or changes in bowel habits and stool consistency.

“If you have any of these symptoms, even before the age of 45, you don’t have to wait for a colonoscopy right now. These symptoms may be a sign of colon cancer. That’s why, “says Malam.