While the rate of colon and rectum cancer has fallen in people older than age 54, the rate in younger people is rising. Since 1994, in people below the age of 50, the incidence has risen 51%. But at any age, in developed countries, colorectal cancer is unfortunately too common, and near the top of the list of cancer mortality.
Colon and rectum cancer screening
Just recently the American Cancer Society (ACS) was the first major medical group to recommend that the age for screening for colorectal cancer be dropped from age 50 to 45. The idea is to find cancers, or pre-cancerous polyps, at an earlier stage and save lives.
Value of cancer screening
Colon cancers typically start as polyps in the colon. These polyps are not yet cancers, but may evolve into cancer over time. The idea of screening is to find these pre-cancerous polyps and remove them before they become cancerous. Polyps can almost always be removed without any external incision. Using a colonoscope (a long flexible tube inserted in the rectum), the polyps can be identified and pulled out.
Researchers believe that the increased use of colonoscopy procedures is the reason that the rate of this cancer has fallen in people above age 54. With this procedure, the pre-cancerous polyps are removed, so these people do not progress to getting cancer.
But until now, following the accepted guidelines, most colonoscopy procedures to look for polyps or cancers have been done in people older than 50, But if screening became more common in younger people (below age 50), it is likely that the rate of this cancer in younger people would decrease. This is the idea for the new recommendations of the ACS.
Types of screenings
We will discuss in a future post more details about the procedure of colonoscopy, but this procedure with the flexible tube is considered the best possible way to detect early cancers of the colon or rectum. However, colonoscopy is more complex than other ways to screen for this cancer, and carries a small risk of complications. For this reason, there are other, less “invasive” ways to screen for colon cancer. These methods—such as checking a fecal sample for hidden blood—are much easier to carry out, but they may not detect some cancers that would have been detected by the more complete colonoscopy exam.
Why cancers are increasing in younger people
Medical researchers are not certain why the rate of colon and rectum cancer in people under 50 have increased. They believe however, that the most likely reasons include a higher obesity rate, more sedentary behavior, and increased intake of processed foods. All these things increase the risk of colon and rectal cancer.
What you should do
Certainly if anyone in your family has had cancer of the colon or rectum, you should undergo some type of screening exam before age 50. Now the new ACS recommendations are calling for screening in everyone, even people without this family history. If you are above 40 years old, talk to your doctor for advice about what you should do.
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