COMMENTARY

Why Screen Younger Adults for Colon Cancer?

Arefa Cassoobhoy, MD, MPH

Disclosures

June 22, 2018

Hello. I'm Dr Arefa Cassoobhoy, a practicing internist, Medscape advisor, and senior medical director for WebMD. Welcome to Morning Report, our 1-minute news story for primary care.

The American Cancer Society has made a significant change to their colorectal cancer screening recommendations.They now say that for people at average risk, screening should begin at age 45 rather than age 50.

This differs from the US Preventive Services Task Force guidelines, which are now 2 years old.

While mortality rates have declined for adults age 55 and older, colorectal cancer remains the second leading cause of cancer death in the United States. And recent data show that mortality among young adults is on the rise. The rates of colon and rectal cancer for those under age 50 have doubled since 1994.

The ACS believes that the balance of benefits and harms favor earlier screening. They continue to recommend high-sensitivity stool-based tests or structural visual exams. All positive results by non-colonoscopy methods should be followed up with a colonoscopy. Now we'll have to wait and see how health insurance plans address paying for this screening at age 45.

Follow Dr Cassoobhoy on Twitter at @ArefaMD

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