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New Colorectal Screening Guidelines: 3 Things to Know

POSTED BY: Florida Hospital

The American Cancer Society recently announced that colon and rectal cancer screenings for adults should begin at age 45 instead of 50, as previously advised. In the U.S., colorectal cancer is the second-leading cause of cancer-related deaths among cancers that affect both men and women, according to the Centers for Disease Control and Prevention.

We consulted Allen Paul Chudzinski, MD, FACS, FASCRS, Director of Colon and Rectal Surgery at Florida Hospital Tampa, to learn more about what these new guidelines mean for you.

1. Colorectal cancer is trending younger

Dr. Chudzinski says the updated guidelines are likely a response to the rising rate of colon cancer found in younger adults.

“This study looked at people since the year 2000 and found that those who were 65 and older, their rates of death from colon cancer went down,” said Dr. Chudzinski. “And we think that’s because screenings are more available and more people are getting screened. But surprisingly, patients who were 55 and younger had an over 50 percent increase in rates of colon cancer. That was shocking.”

He explained that historically, a younger person typically developed colorectal cancer if they had a high risk of hereditary colon cancer. But the study that inspired these new guidelines shows otherwise.
“I can tell you that I’ve personally been seeing more of it in younger people, but you would expect most of them to have had a hereditary reason for their cancer — mutations that make them prone to it. But many of these are patients don’t have the mutation for developing cancer at all.”

2. Start getting screened at least at age 50, if not sooner

“Ultimately, I agree with starting at 45, and I think it will become the new standard, but you have to look at some of the fine print,” Dr. Chudzinski says of the new ACS guidelines.

“There is a strong recommendation that screenings start at 50, but this is a new ‘qualified’ recommendation that it should be done at 45,” he said. “In general, they are saying 50 is still the highest standard, but based upon the expertise of oncologists and gastroenterologists who looked at these studies, and the fact that the rate of cancer in people 55 and younger has dramatically increased, we have a qualified recommendation that indicates you should start having colonoscopies at age 45.”

Dr. Chudzinski also pointed out a key omission in the guidelines: “They don’t make any mention of African-Americans. Prior to now, the recommendations were that people should start at age 50 — unless you’re African-American, then it’s 45. Because we saw more aggressive and severe colorectal cancer at a younger age in African-Americans.”

3. Colonoscopies are the still gold standard for screenings

Dr. Chudzinski acknowledged that there are various types of screenings besides colonoscopy, but, “if any results from those tests are positive, you know what you’re supposed to do? Get a colonoscopy.”

What makes colonoscopies so valuable is their ability to not only detect cancer, but also prevent it. Removal of small polyps during the procedure can stop any potential cancer from developing. It’s also an incredibly safe and effective procedure that takes only a few hours to complete.

We want you to be proactive about your health, but understand you may have questions or concerns about what choices to make. If you’d like more information about colorectal screenings or want to start the scheduling process, we’re glad to be your guide. Please visit our website or give us a call at 855-303-DOCS (3627).