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Colorectal cancer screening is advised from age 45

2021-05-21T18:02:55.279Z


US Task Force Lowers Recommended Age to Start Colorectal Cancer Screening to 45 Years Now they recommend colonoscopies from the age of 45 16:58 (CNN) - The United States Preventive Services Task Force lowered the recommended age for colon and rectal cancer screening from 50 to 45 years. The task force, which is the main medical guidance panel in the United States, released a draft of the recommendation in October. The final recommendation statement, published Tuesday in the journ


Now they recommend colonoscopies from the age of 45 16:58

(CNN) -

The United States Preventive Services Task Force lowered the recommended age for colon and rectal cancer screening from 50 to 45 years.

The task force, which is the main medical guidance panel in the United States, released a draft of the recommendation in October.

The final recommendation statement, published Tuesday in the journal JAMA, says that all adults ages 45 to 75 should be screened for colorectal cancer.

This recommendation is directed to asymptomatic, medium-risk people without a previous diagnosis of colorectal cancer, without a history of colon or rectal polyps, and without a personal or family history of genetic disorders that put them at greater risk.

The task force also recommended screening among adults 76-85 years of age based on the patient's general health, prior exam history, and preferences.

Colorectal cancer, now more present in young adults 1:08

In its 2016 recommendation, the Preventive Services Task Force (USPSTF) suggested starting screening at age 50.

“We believe that with screening tests from the age of 50, we prevent about 50 cases of colorectal cancer in a population of 1,000 people and we avoid about 25 deaths.

If we go down to the age of 45, we will avoid two or three more cases and perhaps one death, ”Dr. Michael Barry, vice chairman of the task force, told CNN.

"We thought it was substantial enough to change the recommendation and drop to age 45."

With the official recommendation, colorectal cancer screening services for people ages 45 to 75 will be covered by most private insurance plans, with no copay.

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There were more deaths from cancer than from covid-19 in 2020 1:16

"The implication is that, for many people, there will be fewer barriers to getting screened between the ages of 45 and 49," said Barry, noting that there may be a time lag before insurance coverage kicks in. vigor.

Colorectal cancer is the third leading cause of cancer death, with an estimated 52,980 people expected to die from it in the United States in 2021. Although most cases are diagnosed in people 65 to 74 years of age, the recommendation reflects a trend in recent years of cases among younger people.

Orientation change driven by a worrying trend

The final recommendation states that 10.5% of new cases of colorectal cancer occur in people under 50 years of age, and cases among adults between 40 and 49 years increased by almost 15% between 2000-2002 and 2014-2016. .

"It's a major area of ​​concern and research theories abound," Dr. Benjamin Lebwohl, a gastroenterologist at NewYork-Presbyterian and Columbia University Medical Center, told CNN.

"To some extent, it may be driven in part by obesity, but there are many people under the age of 50 who are not obese and who are developing colorectal cancer without any discernible risk factors."

Although doctors are still not sure why more cases occur in the younger age group, they say that screening people for cancer at a younger age will save lives.

If colorectal polyps are found early enough, they can be removed before they turn into cancer.

To support its decision, the task force commissioned a review of colorectal cancer screening tests in the United States, which included 33 studies on the efficacy, accuracy of the tests, and the harms of the tests.

It also took into account a modeling study, which estimated the years of life gained from colorectal cancer screening to be 171 to 381 per 1,000 people in their 40s.

The models showed that the number of additional life years gained from screening after age 75 was relatively small.

The researchers calculated that reducing the age of screening from 50 to 45 years could lead to a gain of an additional 22 to 27 years of life, an additional 161 to 784 colonoscopies, and an additional 0.1 to 2 complications related to colonoscopies. screening tests per 1,000 people.

Starting screening at age 45 "provides an effective balance between colonoscopy burden and life years gained," the research states.

Disproportionate impact on black adults

The USPSTF now joins groups like the American Cancer Society in recommending the lower age threshold for screening adults at medium risk for colorectal cancer.

The American Cancer Society made the switch from age 50 to age 45 in 2018. In 2017, the US Cross-Societies Task Force on Colorectal Cancer recommended that screening begin at age 45 in black Americans and at age 50 in other groups .

This is because black Americans are more likely to get and die from colorectal cancer.

In its new recommendation, the task force cited colorectal cancer rates from 2013 to 2017 showing 43.6 cases per 100,000 black adults, compared to 37.8 cases per 100,000 white adults.

The USPSTF said it was unable to make a separate, specific recommendation on colorectal cancer screening in black adults due to limited evidence.

"No one knows the definitive answer to why black Americans seem to have an excessively higher number of colorectal cancer cases," Dr. Carl Crawford, a gastroenterologist at NewYork-Presbyterian and Weill Cornell Medicine, told CNN.

"It is not clear whether the reason for this is lower review rates, follow-up after review, or the type of treatments these patients receive."

Crawford said more research is needed on these disparities.

"It may not just be genetic factors," he said.

"There may be more environmental or health system access issues that we really haven't been able to identify."

"It's a time bomb with a 10-year fuse"

Barry said he hopes the new guide will boost screening for all groups and ages included in the recommendation.

The task force noted that, in 2018, 31% of eligible adults had not kept up with colorectal cancer screenings.

That was before scores of people skipped cancer screenings, along with other preventive care measures, during the coronavirus pandemic.

Another Covid-19 Harm: Fewer Cancer Detections (June 2020) 4:36 AM

"I think the screening delay due to COVID-19 is a time bomb with a 10-year fuse," said Dr. Michael Zinner, CEO and chief medical officer of Baptist Health's Miami Cancer Institute.

"During the peak of the pandemic, we learned that colonoscopy tests had been reduced by 85% from the previous year's baseline," he noted.

"When this is modeled over time, the modeling says that in 10 years we could predict 4,000 additional deaths from colon cancer."

Doctors are urging patients to catch up on missed screenings, especially now that more and more Americans are getting vaccinated against the coronavirus.

"I have patients who contact me and ask me to schedule their colonoscopy for a date two weeks after the second dose of their vaccine," Lebwohl said.

They have a lot of intention of doing it.

There are several colorectal cancer screening options, such as colonoscopies and fecal tests.

"Based on the evidence, there are many tests available that can effectively detect colorectal cancer, and the correct test is precisely what is done," said Martha Kubik, a member of the USPSTF, professor and director of the School of Nursing. at the George Mason University School of Health and Human Services.

- CNN's Jacqueline Howard contributed to this report.

Cancer Colorectal Cancer

Source: cnnespanol

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