Early colorectal cancer screening is recommended

An influential and independent task force consisting of preventive and evidence-based medical professionals recommends that adults begin screening for colorectal cancer at age 45 instead of 50. Death due to illness.

“We know that colorectal cancer is the third leading cause of cancer death and that screening for colorectal cancer can save lives,” said Boston, a member of the US Preventive Medicine Committee. Jungwon, Interim Chief Scientific Officer at the Tufts Medical Center in Boston, said. “Looking at the data, we found that starting screening at age 45 instead of 50 could be profitable and save more lives.”

The final recommendation statement, released at JAMA on Tuesday, updated the guidelines about five years ago, with mixed data on lowering the starting age, with only “moderate” benefits to start screening before age 50. I concluded that I couldn’t get it.

The Task Force recommendations are in close agreement with the draft published in October, and given the continued increase in cases of colorectal cancer in young adults since 2018, regular screening is It is in close agreement with the guidance of the American Cancer Society, which states that it should start at 45. According to a paper published in the JAMA Open Network in April, colorectal cancer is estimated to be the leading cause of cancer-related deaths in people aged 20-49 years by 2030.

External experts say that consensus between key organizations can have a wide range of impacts on access to care. Robert Smith, senior vice president of cancer screening at the American Cancer Society, said many insurers cover their insurance based on recommendations from the Task Force to evaluate screening tests, counseling services, and preventatives. Stated.

The final recommendation is required by affordable care methods to cover regular colorectal cancer screening for people aged 45 to 75 years with most private insurance plans at no out-of-pocket cost to patients. Will be a service. “Physicians are very careful about the burden of care for uncovered procedures, which affects them,” Smith said.

The Task Force recommends two screening methods. Direct visualization tests such as colonoscopy, which are considered the gold standard, and stool-based tests. Kimmy Ng, director of the Young-onset Colorectal Cancer Center at the Dana-Farber Cancer Institute in Boston, has been updated by making these tools “available to millions of individuals in the United States.” He said the guidelines would have a “major impact.”

The incidence of colorectal cancer, which causes tumors in the colon and rectum, has increased by about 2% each year among people under the age of 50 in recent years, with experts who have not yet identified what is causing the rise. I’m worried. According to a March report from the Cancer Society, this trend is primarily driven by the rate of increase in young whites, but blacks have historically been hit far more than other groups.

“The African-American community has shown high incidence and mortality for colorectal cancer. There is a question of whether this is due to biology or access to care,” he said. Robin Mendelsohn, co-director of the Center for Young, said. The development of colorectal cancer at the Memorial Sloan-Kettering Cancer Center in New York was mentioned in an interview in October. “We believe that more and more access to care is likely.”

Blacks are “less likely to undergo both timely follow-up of positive screening tests and high-quality colonoscopy, contributing to increased mortality,” according to a report from the Cancer Society.

A Task Force advisory statement noted that experts examined the potential benefits and harms of colorectal cancer screening across racial and ethnic groups and found no evidence to support changes in guidelines for different populations. Did. According to the statement, if you have no family history or no known risk factors, you should start screening at age 45 instead.

However, given that cancer has a disproportionate effect on blacks, the Task Force called for further research and asked clinicians, “Especially reaching out to black patients aged 45-75 years, recommended effective colon. We strongly encouraged people to receive the rectum and ensure that they have the opportunity to benefit. We hope that cancer screening tests will help reduce inequality, “Won said.

Conversations between healthcare providers and their patients are very important in preventive care, according to Smith. “If these conversations don’t take place, it’s easy for people to think,” Well, this doesn’t really apply to me, “or” I have no symptoms, “or” I don’t. ” “Risk,” he said. “Having guidelines seems to affect some people, but others really need this extra tweak.”

Recognizing that colorectal cancer could pose a risk to people under the age of 50, who surged in 2020 after actor Chadwick Boseman died in August.Boseman was diagnosed with stage 3 colon cancer in 2016, Proceeded to stage 4 before his death.. He was 43 years old.

Despite strong evidence that screening is effective, about a quarter of the traditionally screened groups aged 50-75 have never been tested, Wong said. It is important to normalize healthcare providers talking about colorectal cancer, raise awareness of the importance of screening, and reassure people about the general safety of colonoscopy, Ng said. ..

“These guidelines are just words on paper or on the screen, unless there is a commitment from various stakeholders to actually start implementing all these recommendations and ensure that the barriers are removed,” she said. It was.