U.S. panel: Colon cancer screening should start earlier - at age 45

Adults should start screening for colorectal cancer routinely at the age of 45, instead of waiting until 50, a U.S. task force recommended Tuesday, in a move that reflected the sharp rise in the number of colon and rectal cancers in young adults.

The proposal by the U.S. Preventive Services Task Force still must be finalized. Its guidance on screenings and preventive care services is followed by doctors, insurance companies and policymakers.

Though the vast majority of colorectal cancers are still found in those 50 and older, 12% of the 147,950 colorectal cancers that will be diagnosed this year - some 18,000 cases - will be found in adults under 50, according to an American Cancer Society study. The incidence of colorectal cancer, which dropped steadily for people born from 1890 to 1950, has been increasing for every generation born since the mid-20th century.

Many early onset cancers are diagnosed in people as young as their 20s and 30s who will not be covered by the draft recommendation. For example, Chadwick Boseman, the actor who starred in "Black Panther" and other films, died in August at 43 from colon cancer that was diagnosed several years earlier. Still, advocates for people with cancer hailed the proposal by the task force as a major step forward, saying it has the potential to save tens of thousands of lives.

The panel emphasized that health care providers should especially encourage Black men and women to be screened at 45, because of high rates of the disease and higher death rates in African American communities.

"This is probably the best news for patients and survivors of colorectal cancer that I can remember over the last 10 or 20 years," said Michael Sapienza, chief executive of the Colorectal Cancer Alliance, an advocacy group. "We have been fighting for so long for this. It is a huge win for our community, and a huge milestone for the colorectal cancer community and for cancer care."

Doctors who treat cancer patients praised the recommendation as well, saying it would draw attention to concerns about early-onset colon and rectal cancer, and encourage both primary care physicians and young adults to heed warning signs like rectal bleeding and changes in bowel movements. The panel declined to lower the screening age when it last updated its recommendation in 2016.

"Lives will be saved," said Dr. Kimmie Ng, director of the Young-Onset Colorectal Cancer Center at the Dana-Farber Institute in Boston.

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