Thursday, 21 June, 2018

Cancer group says colon screening should start at 45, not 50

Colonoscopy Colon cancer screening should begin at 45-American Cancer Society
Ben Pena | 02 June, 2018, 03:30

Today's action by the American Cancer Society does not mean colorectal cancer screening tests will now be covered by insurance plans. Vital signs: colorectal cancer tests saves lives. Previously, the recommended age to begin screenings is 50, but increased rates of cancer and death in those younger than 50 have encouraged health care providers to revise the starting age.

Outside of the cost and the frequency in which a test is recommended to be done, "all these tests are approximately equal in their value and can be offered", Wender said.

Shares of diagnostic company Exact Sciences Corp, which makes Cologuard that helps detect colorectal cancer, jumped more than 10 percent after the guideline was revealed.

The researchers also commissioned a microsimulation modeling study involving a model called MISCAN, which simulates colorectal cancer incidence and mortality and estimates risk factors and the impact of screening and treatment practices.

Someone born in 1990 now has twice the risk of colon cancer, and four times the risk of rectal cancer, as someone born in 1950, the new report noted.

The organization, which announced the change in its guidelines Wednesday, said extensive analysis showed that lowering the starting age for screening would save lives.

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Over the past two decades, the incidence of colorectal cancer has declined steadily among people older than 54, largely because screening has increased, allowing the identification and removal of polyps that can become malignant.

The U.S. National Cancer Institute has more on colon cancer. Her experience spans from leading public health efforts and developing statewide colorectal cancer screening programs to managing a community oncology practice and overseeing its clinical trials program. "Whether it's 45 or 50, the most important thing is for people to get screened and keep screening". Tests showed Fiske had colorectal cancer that had spread to his liver.

"[Some] are marathon runners who don't eat red meat, don't smoke, do everything right and say 'Why did this happen to me?'" Mendelsohn said, noting the patients have often seen doctors who told them they could not have cancer so young. Based on microsimulation modeling that showed a favorable risk:benefit ratio for screening at age 45, the recommendation comes with the "expectation that screening will perform similarly in adults ages 45 to 49 as it does in adults for whom screening is now recommended".

"The revision to the American Cancer Society guideline for the average risk population from 50 to 45 is a critical step to impact the increasing rate of colorectal cancer in the young (under age 50)". Those with a family history or a history of inflammatory bowel disease such as Ulcerative Colitis may need to start much younger.

Colon and rectal cancers have increased 51% among adults under age 50 since 1994, the cancer society said.

Breedlove said she's heartened by the change but believes the guideline should go even lower. "So it's preventative, not just early diagnosis", she said, adding that she thinks the risks of screening younger outweigh the benefits.

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