New guidelines say colorectal cancer screenings should begin earlier in life

Posted at 6:22 AM, Jun 04, 2018
and last updated 2018-06-04 07:22:42-04

If you are in your mid-40s and haven’t had your colon checked, it may be time. New guidelines from the American Cancer Society say colorectal cancer screening should start at age 45, not 50. 

There is both good and bad news when it comes to the disease. 

Colorectal cancer is the third most commonly diagnosed cancer in Americans,  and is a highly treatable and often curable disease when localized to the bowel. 

According to a study by the American Cancer Society, the overall number of colon cancer deaths are down, and cancer rates are decreasing for those over 50, but there has been a sharp rise in colon cancer for younger people. 

"What we have seen in the past years, and the studies, has shown that people are developing cancer at an earlier age than we have thought.  So moving it to the age of 45, we are able to detect cancer at the earliest stage in the younger patients and potentially cure them or prevent them from developing cancer," said Thomas-Span Clinic at Corpus Christi Medical Center Hematologist Dr. Aftab Mahmood. 

Oncologist and Hematologist Dr. Aftab Mahmood says now all men and women will be eligible for colonoscopy screenings starting at age 45. 

"As far as prevention is concerned, there are certain things that diets or medication that you can take. Aspirin has shown to lower the risk of colon cancer from developing. Otherwise prevention is basically doing the screening procedures and removing the polyps that can eventually transform into colon cancer," said Dr.Mahmood. 

Some people may have many symptoms, and some people do not experience any symptoms until the cancer is more advanced.  

"So common symptoms include blood in the stool, rectal bleeding, abdominal pain, they feel pressure with bowel movement, and even after that, they continue to have polyp pressure. Unintended weight loss, loss of appetite, and fatigue," said Dr. Mahmood. 

Colorectal cancer is the third most commonly diagnosed cancer in Americans, according to the American Cancer Society. Colon cancer will be diagnosed in more than 95,000 people this year and nearly 40,000 will be diagnosed with rectal cancer. 

Only about two-thirds of Americans who should get screened for colon cancer actually do. 

Most colon cancer occurs in adults 55 and older, and the good news is rates of cases and deaths have been falling for decades. Colon cancer, combined with rectal cancer, is the second leading cause of cancer death in the U.S. This year, more than 140,000 Americans are expected to be diagnosed with it, and about 50,000 will die from it. 

Prevention and early detection: 

Regular screening can even prevent colorectal cancer. A polyp can take as many as 10 to 15 years to develop into cancer.  

With screening, doctors can find and remove polyps before they have the chance to turn into cancer. 

ACS Recommendations 
The ACS recommends that people at average risk* of colorectal cancer start regular screening at age 45.  

This can be done either with a sensitive test that looks for signs of cancer in a person’s stool (a stool-based test), or with an exam that looks at the colon and rectum (a visual exam). These options are listed below. 

People who are in good health and with a life expectancy of more than 10 years should continue regular colorectal cancer screening through the age of 75. 

For people ages 76 through 85, the decision to be screened should be based on a person’s preferences, life expectancy, overall health, and prior screening history. 

People over 85 should no longer get colorectal cancer screening. 

For screening, people are considered to be at average risk if they do not have:

  • A personal history of colorectal cancer or certain types of polyps
  • A family history of colorectal cancer
  • A personal history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease)
  • A confirmed or suspected hereditary colorectal cancer syndrome, such as familial adenomatous polyposis (FAP) or Lynch syndrome (hereditary non-polyposis colon cancer or HNPCC)
  • A personal history of getting radiation to the abdomen (belly) or pelvic area to treat a prior cancer 

For people at increased or high risk

  • People at increased or high risk of colorectal cancer might need to start colorectal cancer screening before age 45, be screened more often, and/or get specific tests. This includes people with: * A strong family history of colorectal cancer or certain types of polyps (see Colorectal Cancer Risk Factors)
  • A personal history of colorectal cancer or certain types of polyps
  • A personal history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease)
  • A known family history of a hereditary colorectal cancer syndrome such as familial adenomatous polyposis (FAP) or Lynch syndrome (also known as hereditary non-polyposis colon cancer or HNPCC)
  • A personal history of radiation to the abdomen (belly) or pelvic area to treat a prior cancer

Colorectal cancer might not cause symptoms right away, but if it does, it may cause one or more of these symptoms:

  • A change in bowel habits, such as diarrhea, constipation, or narrowing of the stool, that lasts for more than a few days
  • A feeling that you need to have a bowel movement that’s not relieved by having one
  • Rectal bleeding with bright red blood
  • Blood in the stool, which may make the stool look dark
  • Cramping or abdominal (belly) pain
  • Weakness and fatigue
  • Unintended weight loss 

Many of these symptoms can be caused by conditions other than colorectal cancer, such as infection, hemorrhoids, or irritable bowel syndrome. Still, if you have any of these problems, it’s important to see your doctor right away so the cause can be found and treated, if needed. 

If you’ve been diagnosed with colorectal cancer, your cancer care team will discuss your treatment options with you. It’s important that you think carefully about each of your choices. Weigh the benefits of each treatment option against the possible risks and side effects. 

Local treatments:
Some treatments are called local therapies. This means they treat the tumor without affecting the rest of the body. These treatments are more likely to be useful for earlier stage cancers (smaller cancers that haven’t spread), but they might also be used in some other situations.  

Types of local therapy used for colorectal cancer include:

  • Surgery for Colon Cancer 
  • Surgery for Rectal Cancer 
  • Ablation and Embolization for Colorectal Cancer 
  • Radiation Therapy for Colorectal Cancer

Systemic treatments: 
Colorectal cancer can also be treated using drugs, which can be given by mouth or directly into the bloodstream. These are called systemic therapies because they can reach cancer cells throughout the body. 
Depending on the type of colorectal cancer, different types of drugs might be used, such as:
* Chemotherapy for Colorectal Cancer
* Targeted Therapy Drugs for Colorectal Cancer
* Immunotherapy for Colorectal Cancer 

Common treatment approaches Depending on the stage of the cancer and other factors, different types of treatment may be combined at the same time or used after one another.
* Treatment of Colon Cancer, by Stage
* Treatment of Rectal Cancer, by Stage