Current recommendations call for most people to begin colon cancer screenings at age 50. But the U.S. Preventive Services Task Force wants to lower that to age 45 — just as the American Cancer Society recommended two years ago.
Dr. Clifford Simmang, a colon and rectal surgeon with Baylor Scott White Health, explained to KERA’s Sam Baker why the task force recommendation carries more weight.
INTERVIEW HIGHLIGHTS
Why The Task Force Recommendation Matters
The task force itself is a 16-member cohort of individuals specialized in preventative health epidemiology. Whenever you consider a screening test, physicians always look at the positive aspect of that, but there are risks to any test that's performed and the USPSTF takes all of that into consideration.
Because this is a national task force, this recommendation will carry weight that insurance companies probably will start to follow.
What Expanding The Age Range To 45 Could Accomplish
Colon cancer tends to be a disease still most commonly seen in people over 60. But the incidents in younger people has been increasing.
When I was faculty at UT Southwestern [Medical Center], we noticed in the Parkland [Hospital] population between the '80s and the '90s, that we saw about a 5% increase in younger people under the age of 50.
The current publication by the task force also notes this goes back to the '80s where they were seeing an increase in the people who are 20 to 39. So younger people about 1% per year dating back to the '80s. So, this has been going on for the last 40 years.
More recently, we've seen the impact of several high profile individuals who are dying from colorectal cancer at an early age. And I think that draws more public attention and then more awareness. And then the societies react to that by looking at their data more critically in those ages.
And it's not just a U.S. phenomenon. Europe has seen the same thing. India is seeing the same increase.
What Accounts For Increasing Rates In Younger People?
The speculation has been a change in lifestyle over the years. It's a culmination of the sedentary lifestyle with the change in diet and an increase in obesity in young people. And these are factors found to be associated with colon cancer.
Another Benefit Of Expanding The Age Range to 45.
A colonoscopy is the only screening test you can have where you can find a polyp that is going to be cancer in four or five years, remove it, and prevent cancer - all in the same test. So by starting screening earlier, it's felt that we will prevent cancer by getting more people to have their colonoscopies.
In the past 20 years, we saw a decrease in colorectal cancer overall, but this decrease has been in patients 55 years and older. This decrease is directly attributed to having a colonoscopy.
Why 55? The screening age to start is 50. Most people say, “I don't really want that test. I think I'll wait.” But with the age range extending down to 45, we're also seeing the increase in that age range. So the recommendation has been increased to increase the number of people that can benefit.
What To Do About Reluctance To Get That Screening?
I think that also comes back to what you're doing today to help get the word out to people, to let people know screening is important. It can save lives and the mantra should be, "get the polyp, prevent the cancer."
RESOURCES:
Opportunity for public comment on screening recommendations:
Interview highlights were lightly edited for clarity.
Got a tip? Email Sam Baker at sbaker@kera.org. You can follow Sam on Twitter @srbkera.
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