Dear Dr. Walt,
What do you think of the new recommendations for colon cancer screening to begin at age 45? If this just overkill or a way for GI doctors to make more money?
—Skeptical in Idaho
In May of this year the American Cancer Society (ACS) announced an update to its guideline for colorectal cancer screening. ACS is now calling for adults to be screened “beginning at age 45 rather than 50” saying it had concluded that an earlier start to screening “would save lives.”
The ACS points out that since screening has become more common among adults over 50, “the incidence of colorectal cancer has declined steadily among people older than 54.” Yet, “since 1994, there has been a 51 percent increase in the rate of the disease among those younger than 50.”
The ACS points out that “the initial test does not have to be a colonoscopy,” but could instead “be one of several other tests, including home stool tests available by prescription,” though the group also recommended that “worrisome results on any test other than a colonoscopy need to be followed up with a colonoscopy.”
The new recommendation “would extend routine colorectal cancer screening to an additional 22 million American adults between the ages of 45 and 49,” so the impact is huge. Also, the US Preventive Services Task Force decided a few years ago not to lower its recommended age from 50. We’ll have to wait to see if they change their recommendation. As for me and my patients, I’m going with the ACS on this one for now.
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