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Screening for colorectal cancer is now recommended for all people, beginning at age 45 rather than 50. The U.S. Preventive Services Task Force recently updated its guidelines to begin screening five years earlier, citing a comparative modeling study that found colorectal cancer screening demonstrates a benefit for people at age 45.
"What we're seeing now is more people developing colorectal cancer under the age of 50. In fact, 10% of colorectal cancer cases now are going to occur in people who are under the age of 50," says Dr. Lisa Boardman, a Mayo Clinic gastroenterologist.
Watch: Dr. Lisa Boardman talks about updated colorectal cancer screening guidelines.
Journalists: Broadcast-quality sound bites with Dr. Boardman are available in the downloads at the end of the post. Please courtesy: "Lisa Boardman, M.D./Gastroenterology/Mayo Clinic."
"Colorectal cancer is the third leading cause of cancer death in the U.S. It affects men and women equally. And we expect about 50,000 people will die this year from colorectal cancer," says Dr. Boardman.
Rates of colorectal cancer are higher in Black Americans; American Indians; Alaskan Native adults; those with a family history of colorectal cancer; and adults with other health factors, including diabetes. The U.S. Preventive Services Task Force says it recommends that all adults get screened, beginning at 45, even if these risk factors are absent.
"Half of the cases that occur under the age of 50 are going to be in that 40-to-45 to the 50-year-old decade of life," says Dr. Boardman. "And with that average-risk screening dropping down to starting at age 45, the hope is that cancer would be caught earlier, or even better, catching it at the polyp stage, which is the precancerous lesion. The benefit of finding it at that stage is that you can remove a polyp and prevent that person from getting cancer."
Dr. Boardman says the importance of screening is to find colorectal cancer before a person develops symptoms.
"We know that screening works in people age 50 and older. We've seen a reduction in colorectal cancer cases and deaths due to that condition. And now applying it to younger people, we hope will have a similar impact," says Dr. Boardman.
Types of screening and recommended intervals include:
- High-sensitivity gFOBT or FIT every year.
- sDNA-FIT every one to three years.
- CT colonography every five years.
- Flexible sigmoidoscopy every five years.
- Flexible sigmoidoscopy every 10 years and FIT every year.
- Colonoscopy screening every 10 years.
Dr. Boardman says the task force's recommendation is also good news for patients.
"It is an endorsement for doctors, for insurance companies, for the policy-forming organizations who helped to determine whether you'll have your testing done covered by insurance. This was the crucial step. And this opens those doors for people to know that they can get that screening done and that their insurance company should cover it."
For the safety of its patients, staff and visitors, Mayo Clinic has strict masking policies in place. Anyone shown without a mask was recorded prior to COVID-19 or recorded in an area not designated for patient care, where social distancing and other safety protocols were followed.
