Clinicians should now order routine colorectal cancer screenings for patients at age 45, the U.S. Preventive Service Task Force recommended on Tuesday, including those who have no symptoms or a personal or family history of the disease.
The new draft recommendation by the national body of health-care experts takes the age of screening down to 45 years old from 50, responding to a sharp increase among younger colon and rectal cancer patients. The recommendation must still be finalized after public comment.
Colorectal cancer is the third leading cause of cancers deaths in the country. Despite strong evidence that screening for colorectal cancer is highly effective, about a quarter of people ages 50 to 70 have never been screened.
“Unfortunately, not enough people in the U.S. receive this effective preventive service that has been proven to save lives,” says Task Force chair Alex Krist, a professor of family medicine and population health at Virginia Commonwealth University. “We hope that this recommendation to screen people ages 45 to 75 for colorectal cancer will encourage more screening and reduce people's risk of dying from this disease.”
Stanford Health Policy’s Douglas K. Owens, past chair of the Task Force, said health-care providers should especially encourage Black men and women to be screened at 45. A recent study found the incidence of colon cancer is 20% higher among African Americans than whites — and the mortality rate is 35% higher among Blacks.
“Black adults get colorectal cancer more often and are more likely to die from it, so screening is especially important,” Owens said. “Screening for colorectal cancer is one of the most important preventive services that clinicians can offer, and we know that not everyone who should be screened is screened.”
The recent death of 43-year-old Chadwick Boseman, the African American actor who played the Black Panther, surprised many who believe the cancer typically only hits the elderly.
But the American Cancer Society notes the rate at which people are diagnosed with colorectal cancer in the United States has been dropping among people 65 and older — by 3% annually from 2011 to 2016. But for those 50 to 64, the trend has reversed, with rates rising at about 1% a year from 2011 to 2016; and by 2.2% per year in people younger than 50.
“In our new draft guideline, we recommend earlier screening because the epidemiology of colorectal cancer has changed, with increasing numbers of younger people getting cancer,” Owens said, adding there are many tests to effectively screen for colorectal cancer.
The Task Force is an independent volunteer panel of experts in prevention and evidence-based medicine whose final recommendations are followed by most primary care physicians and clinicians nationwide.
The draft recommendation statement, draft evidence review, and draft modeling report have been posted for public comment on the Task Force website at www.uspreventiveservicestaskforce.org.