Screening & Diagnostic Testing
The National Comprehensive Cancer Network recommends that people with an average risk begin colorectal screening at age 50. If there is a family history of cancer or Lynch syndrome and/or a personal history of polyps or inflammatory bowel disease, screening before the age of 50 may be recommended by your physician.
In May of 2018, the American Cancer Society (ACS) changed the age of colorectal screening for individuals at an average risk to age 45. While the number of diagnoses for colorectal cancer for adults aged 55 and over has declined over the last 20 years, a disturbing increase of 51% in colorectal diagnoses has been noted for adults under the age of 50 since 1994 (American Cancer Society, 2018). Furthermore, death rates from colorectal cancer in the younger age group are also rising. Based on these statistics, the ACS funded a modeling study that used the age 45 to begin screening rather than at the age of 50. The ACS found that it is more likely that adults will have more favorable outcomes at the lowered age.
ACS’s new screening recommendation is considered a “qualified recommendation” because the hard-scientific data isn’t yet there. The previous recommendation to begin screening at the age of 50 was considered a “strong recommendation” because the scientific evidence is there to support it. It is important to also know that there is more than one organization that makes cancer screening recommendations including the U.S. Preventive Services Task Force (USPSTF). Additionally, whenever screening recommendations change, it is important for you to check with your insurance provider to see which screening guidelines they use as it may affect which screenings are covered as well as your costs and copays.
The ACS recommends people, who are in good health, with a life expectancy of more than 10 years, continue regular colorectal cancer screening through the age of 75. After age 75, through age 85, consideration for screening should include a person’s preferences, life expectancy, overall health, and prior screening history.
A complete physical exam and medical history should be done. The exam will check for any unusual physical signs. A complete medical history is also important to fully understand a person’s health habits, family history, previous illnesses, and past exposure. Additional testing may include: