Colon Cancer Screening Guidelines: An Update

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As the third most common cancer in both men and women, colorectal cancer accounts for almost 9% of all cancer deaths. While colorectal cancer is quite common, treatment can be very effective — as long as the cancer is detected early. Colonoscopies not only detect colorectal cancer, but can even prevent cancer by identifying and removing precancerous polyps during the procedure. The bottom line is that this cancer is preventable, but only if you get the proper screening to detect early signs. This — in accordance with recent data on early prevention — is why the US Preventive Services Task Force guideline updates recommend that colorectal cancer screening begin at age 45 instead of 50.

The data that led to this decision came down to three key findings:

• Incidence rates are just as high in 45 to 49-year-olds as they are in 50-year-olds
• 45 to 49-year-olds have a similar number of advanced polyps as patients between 50 and 59
• Beginning screenings at an earlier age (45 to 59-year-olds) has proven to be more cost effective than dealing (often unsuccessfully) with problems later down the road

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Current colorectal screening recommendations

Follow these new guidelines to reduce your risk of developing colorectal cancer:

• Starting at age 45, individuals with an average risk of colorectal cancer should undergo regular screening with one of six different tests (depending on patient preference and test availability). These tests include an FIT (fecal immunochemical test) or gFOBT (guaiac-based fecal occult blood test) every year, a stool DNA test every three years, a CT colonography or flexible sigmoidoscopy every five years, or a colonoscopy every 10 years. The recommendations do not prioritize any one test over another.
• Following a positive result from a non-colonoscopy screening test, a timely follow-up colonoscopy must be performed to prevent cancer.
• Average-risk adults in good health should continue colorectal cancer screening through the age of 75.
• For patients between 76- and 85-years-old, screening decisions should be made together with clinicians based on patient preference, life expectancy, health status and prior screening history.
• Individuals over the age of 85 should be discouraged from continuing screening. People with a higher risk of colorectal cancer (family history, etc.) should ask their doctor to determine the best age to start screening.

If you are due for a colonoscopy, it's time to schedule an appointment with your doctor. Make an appointment with a gastroenterologist through El Camino Health today.

This article first appeared in the March 2022 edition of the HealthPerks newsletter.