Early Age Onset Colorectal Cancer

September 25, 2022

Recently, The American Cancer Society (ACS) guidelines updated for recommended screening of colorectal cancer from age 50 to 45. This was in response to the increase of early age onset (EAO) colorectal cancer. Awareness of the symptoms and how best to fight CRC is essential.

What is the history of earlier onset colorectal cancer?

In 2017, the Journal of the National Cancer Institute published research from the American Cancer Society (ACS) that indicated that colorectal cancer incidence rates are increasing in young and middle-aged persons, including those in their early 50s. Furthermore, rectal cancer incidence rates are rising, with three out of every ten rectal cancer diagnoses made on individuals under 55.

The news was not new to the colorectal cancer community, which has seen and continues to see a growing number of younger patients diagnosed with the disease–adults who were diagnosed before the age of 50, which has been the suggested screening age for many years.

Recently, The American Cancer Society (ACS) guidelines updated for recommended screening of colorectal cancer from age 50 to 45.

Do the new guidelines affect you?

The updated ACS guidelines, which went into effect in 2012, advise that all average-risk people should be screened for colorectal cancer by age 45. That implies talking with your doctor before then. If your age is higher than 50 years old and have already been tested for colorectal cancer, keeping up with your testing schedule is critical. The US Preventive Services Task Force (USPSTF) advises screening every five years for average-risk individuals (50).

However, other organizations have existing criteria that suggest screening beginning at age 50 for specific populations at higher risk. There are examples of individuals with a personal or family history of colorectal cancer or adenomatous polyps, as well as African Americans and others at increased risk of developing colorectal cancer. Because the ACS change applies to all average-risk individuals rather than only those considered to be at higher risk, it is significant.

Will my insurance cover my screening if I’m 45-50?

Some insurance plans use ACS guidelines, while others reference USPSTF. Comprised of experts in medicine and prevention, the United States Preventive Services Task Force (USPSTF) usually determines what preventive screenings will be covered by insurance (including Medicaid and Medicare), for example, colorectal cancer.

The USPSTF will not change its standards just because the ACS has. This is because the two organizations have two distinct guidelines, which are produced using various strategies, processes, and timelines for review. Coverage of typical-risk persons under 50 is now at the option of insurance companies.

Understand when you need screenings by talking with your healthcare provider, and determine what is covered under your insurance plan by contacting your provider.

I’m younger than 45… Does this affect me?

You should begin screening sooner if you’re a young adult with an increased risk for colorectal cancer (CRC) caused by personal or family history, Lynch syndrome, etc. Discuss signs and symptoms with your healthcare provider if you are under age 45 and don’t have an elevated risk. This is vital to do so that you can create a plan together.

What is the best screening and what age?

As indicated by guidelines, for individuals without a personal or familial history of colorectal cancer, adenomatous polyps, or any hereditary syndrome that would increase their risk, colonoscopy every ten years until age 75 is sufficient screening. 

For those same individuals with no increased risks below are also appropriate methods of screenings: 

However, a colonoscopy is still the gold screening standard. A colonoscopy is when a gastroenterologist uses a medical device to examine your colon and rectum for polyps and other abnormal growths that might be cancer or precancerous. Most of these procedures necessitate colon cleansing or bowel prep the day before. Some types of visual screening even require sedation or general anesthesia. Also, remember that visual screening must be done at a doctor’s office or hospital – not at home.

  • Colonoscopy — A doctor inserts a thin tube with a light, camera, and surgical instruments into the rectum and colon to inspect for tumors, other abnormal tissue, or cancer. If the doctor discovers any pre-cancerous polyps or unusual growths during the procedure, they may remove them. Removing polyps via a colonoscopy usually prevents them from developing into malignancy in the future.
  • Flexible Sigmoidoscopy — A doctor inserts a slender, lit tube with a camera and surgical instruments into the rectum and lower half of the colon to look for growths, abnormal tissue, or cancer. If the doctor sees any pre-cancerous polyps or abnormal growths, they can remove the tissue during the procedure. Removing polyps during a sigmoidoscopy usually prevents them from turning into cancer later.
  • CT Colonography — A CT scan of the colon is used to obtain multiple X-ray pictures. The colon will be gently and temporarily inflated with air via a thin tube tip inserted into the rectum, similar to a CT scan.

Why is Early Age Onset occurring?

Early age onset CRC is gradually becoming more common, but we don’t know why. Research must continue in this area so that we can discover the cause and put a stop to it. We are committed to these efforts and will keep everyone updated as we learn more.

Gastro Florida Can Help You Get Screened

Gastro Florida’s team of expert specialists is here to help. Set up an appointment to be examined, diagnosed, and treated; our objective is to serve and support you in maintaining your gut health.