The U.S. Preventive Services Task Force, which is an independent, volunteer panel of national experts in disease prevention, announced in May 2021 that they recommend lowering the age of a screening colonoscopy from 50 down to 45. This recommendation now falls in line with guidelines from the American Cancer Society made in 2016. This recommendation applies to adults with an average risk of developing colon cancer. Individuals who are considered at higher risk will still follow guidelines established by their healthcare providers.
The Task Force made this recommendation chiefly because U.S. death rates from colon cancer increased 1 percent per year from 2008 to 2017 for adults under the age of 55. However, overall colorectal cancer rates have dropped in the same time period. It is thought that this 5-year advance of colon cancer screening will find more cancers at its earliest change when cure is most possible. In 2021, the American Cancer Society estimates that 53,000 people will die from colorectal cancers.
The Task Force recommendations also include mandates for American Care Act compliant health insurers to follow the new age guidelines and cover this preventative care service. This could be especially significant to Black Americans who on average are at greater risk of developing colorectal cancer and tend to develop these cancers at younger ages.
The announcement came via a statement in JAMA Oncology’s May publication stating, “The recommendation applies to asymptomatic adults age 45 or older who are at average risk of colorectal cancer.” Anyone with a previous diagnosis of colorectal cancer, adenomatous polys, inflammatory bowel disease, or other high-risk factors or family history will follow a more advanced screening process.
The American Cancer Society publishes an excellent guide for all cancer-screening tests, which can be accessed online at www.cancer.org/cancer/colon-rectal-cancer/detection-diagnosis-staging/acs-recommendations.html.
Beginning at age 45 through the age of 75, those with average risk should have a highly sensitive fecal immunochemical test (FIT) or highly sensitive guaiac fecal occult blood test (gFOBT) annually, and if available a multi-targeted stool DNA test (mt-sDNA) every 3 years. These stool diagnostic tests should be available with your annual check-up.
Beginning at age 45, a colonoscopy, which is a visual exam of the colon and rectum, should be done every 10 years. This test is performed by a gastroenterologist either in a facility or at a hospital depending on your insurance and age.
As long as you have negative tests results, you can follow this schedule until you are 75. Individuals between the ages of 76 and 85 should discuss a screening schedule with your healthcare provider predicated on your life expectancy, overall health, and prior screening history. Folks over 85 will not need to be screened.
Today colon cancer is the 3rd leading cause of cancer deaths in young adults, and early detection can help saves lives by treating cancer before it advances. Knowing the possible symptoms is equally important to help find cancer when it’s most treatable.
The American Cancer Society lists the most common symptoms of colorectal cancer to include:
- a change in bowel habits, such as diarrhea, constipation, or narrowing of the stool that lasts more than a few days
- a feeling that you need to have a bowel movement that’s not relieved by having one
- rectal bleeding
- blood in the stool, which might make the stool look dark brown or black
- cramping or pain in the abdomen (belly)
- feeling tired or weak
- losing weight without trying.
While many of these symptoms can be associated with other health problems, it is best to consult your healthcare provider if you experience any of these symptoms for more than a few days or if the symptoms get worse. Talk to your healthcare provider about getting your colorectal cancer screening when the appropriate time comes.