Reviewing Gastrointestinal Health Trends: American Cancer Society Publishes New Recommended Age for Colorectal Cancer Screening

WHAT HAPPENED?

In 2017, the American Cancer Society (ACS) revised its cancer screening guidelines, lowering its recommended screening age from 50 to 45 and, in the process, adding 21 million more Americans into the screening population. This change came as ACS researchers observed that colorectal cancer (CRC) incidences among younger adults under the age of 50 increased by 22% from 2000 to 2013 despite an overall decrease in CRC cases. Young adults now have the same risk for CRC as those born in the 1890s.

REASONS:

The cause of this increase has not been conclusively determined. Among general cancer risk factors like smoking or alcohol consumption, the ACS has identified rising obesity and reliance on the “Western Diet” (red and processed meat, refined sugars, high fat foods) as possible risk factors. Some research also suggests that the increase may be partially attributed to genetic or environmental factors. With no indication these lifestyle trends will weaken soon, the incidence of early onset CRC will continue to rise. Based on current projections, the incidence of CRC in patients ages 20 to 34 is expected to increase by 124% by 2030.

IMPORTANCE OF SCREENING:

Since most individuals with CRC remain asymptomatic until late stage, it is crucial that high-risk individuals (i.e. those past the age of 45) are screened. Early detection of CRC can be the difference in patient outcome — diagnosis of Stage I CRC results in a 90% survival rate, whereas later stage diagnoses have a 12% survival rate.

This new screening guideline does not mean that everyone should be tested early, as a colonoscopy before age 45 can be more harmful than helpful. The procedure can cause intestinal perforations and cramping, and it requires a full day of preparation. The CRC risk for adults under the age of 45 is still quite low, and so, for the very (read: VERY) few patients who might actually want a colonoscopy, it is still recommended to hold off until age 45.

While earlier screening for CRC will provide health benefits, it does not solve the systemic issue related to CRC screening: patients don’t like — and, often, don’t get — colonoscopies. While colonoscopies remain the gold standard for CRC diagnosis, it’s a far from perfect solution. In addition to the time and discomfort, the biggest flaw with a colonoscopy is its low compliance rate. Screening is necessary for detection and survival, but almost nobody wants a colonoscopy. So how do we address the entire screening population, especially with an expanded CRC screening population?

GENEOSCOPY’S ROLE

Geneoscopy’s noninvasive diagnostic test alleviates the challenges associated with CRC screening via colonoscopy, allowing to effectively address the 100 million person CRC screening population with a reliable, comfortable, and affordable alternative. Our test will improve screening compliance, early CRC detection, and, ultimately, the lives of our patients.