New Research Recommends Lowering Screening Age for Colorectal Cancer

May 26, 2021 by Alexa Hornbeck
Colorectal cancer is the leading cancer among men and women around the world. (Dreamstime/TNS)

Researchers at Envision Healthcare and Icahn School of Medicine at Mount Sinai recommend lowering the screening age for colorectal cancer from 50 to 45 years old based on new research. 

The Mount Sinai team analyzed approximately 3 million colonoscopies performed at more than 120 of Envision Health’s ambulatory surgery centers, called AMSURG facilities, across the country in the last six years.

The study specifically looked at de-identified data from patients aged 18 to 54 who received a screening or diagnostic colonoscopy and were not undergoing a colonoscopy to monitor previously detected polyps, cancer, inflammatory bowel disease or genetic conditions predisposing to cancer.

Their findings detected colorectal cancer in 0.58% of patients aged 45 to 49, and in 0.53% of patients aged 40 to 44. 

Polyps that had the greatest possibility of becoming cancerous were found in 7.5% of patients aged 45 to 49, and in 5.8% of patients aged 40 to 44.

Researchers noted that a significant portion of patients had polyps present even if they did not have a documented family history of colorectal cancer.

“This data supports efforts to begin screening at age 45 and communicate the importance of on-time screening by early messaging to patients and providers,” said John Popp, medical director for AMSURG.

Colorectal cancer is the second leading cause of cancer death in the U.S., and one of the most preventable. The incidence of colorectal cancer in patients under 50 has nearly doubled since the early 1990s.

Risk factors include a family history of colorectal cancer or pre-malignant polyps, inflammatory bowel disease and lifestyle habits, such as diet, smoking and obesity.  

Colorectal cancer also disproportionately impacts the Black community, as African Americans are about 20% more likely to get colorectal cancer, and about 40% more likely to die from it than most other groups.

The reasons for this reflect differences in risk factors and in health care access, such as lower paying jobs and lack of health insurance, and lack of access to healthy foods.

The symptoms of colorectal cancer are not always easy to recognize, they can include a change in bowel habits, such as diarrhea and constipation, rectal bleeding, abdominal discomfort, or a feeling that the bowel is not completely empty.

“We believe that this will encourage younger patients to get routine screenings on time, at the appropriate age, and with close attention to the individual’s risk factors and symptoms,” said primary investigator, Steven Itzkowitz, MD, director of the GI Fellowship Program at Icahn School of Medicine at Mount Sinai. 

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