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Home / Health / Colon and rectal cancer screenings should begin at 45, say new guidelines

Colon and rectal cancer screenings should begin at 45, say new guidelines



If you're in your mid-40s and have not checked your colon, maybe it's time.

The recently updated guidelines of the American Cancer Society for Colon and Rectal Cancer Screening recommend that adults at average risk be examined starting at age 45 instead of 50, as previously recommended.

The updated guidelines follow what appears to be an increase in colorectal cancer among younger adults.

Those at higher risk include African Americans, Alaska Natives, and people with a family history or personal history of colonic or rectal polyps; Risk factors such as these may require early detection

Published in CA: A cancer journal for clinicians on Wednesday, the updated guidelines also show that there are six adult screening screening options, from non-invasive stool tests to visual examinations such as Colonoscopy, depending on the preference of the patient and the availability of the test.

Other health organizations in the United States ̵

1; such as the US Preventive Services Task Force – still recommend routine screening for colorectal cancer from the age of 50 Colorectal cancer, which includes both colorectal and colon cancer, is lagging behind According to the World Health Organization, the third leading cause of cancer-related deaths in the world.

In the United States, colorectal cancer is the second leading cause of cancer deaths in cancer affecting both men and women, according to the US Centers for Disease Control and Prevention.

Some studies suggest that colon cancer mortality rates increase in US adults under 55 years of age.

After a general decline from 1970 to 2004, the mortality rate of colorectal cancer in 20- to 54-year-olds in the United States rose by 1%. According to a study published last year in the medical journal JAMA,

"behind these numbers are real people and real faces and all of us in the colon cancer world and all gastroenterologists and oncologists have seen more and more young people using these Develop disease, "said Dr. Richard Wender, Chief Cancer Officer of the American Cancer Society, oversaw the development of the new guidelines.

"In people born more recently, the risk of rectal cancer is four times higher than in people born in the '50s (for example, the same age) and doubles the risk of colorectal cancer," he said. "We call this a birth cohort effect. No one really knows why, and that's a big area of ​​interest, but no one questions it.

Six Screening Test Options

In order to produce the updated guidelines, researchers conducted a systematic review of published studies on colorectal cancer screening by English: bio-pro.de/en/region/stern/magazine/ … 3 / index.html [16969002] Researchers also commissioned a model microsimulation model called MISCAN, which simulates the incidence and mortality of colorectal carcinomas and estimates risk factors and the impact of screening and treatment

The researchers' new modeling extension study the analyzes carried out for the recommendations of the US Preventive Services Task Force and assessment of the potential risk and benefit of various colorectal screening strategies in black and white men and women in the United States.

Based on their review and simulation modeling , The researchers identified as of the 45th Lebe Year Efficient Screening Strategies.

T tubular strategies were colonoscoped every 10 years; a computed tomography colonography or "virtual colonoscopy" every five years; a flexible sigmoidoscopy every five years; a multitarget stool DNA test every three years; an immunochemical test to carry faeces annually; or a high-sensitivity guaiac test for occult blood in the household test annually.

The updated guidelines also indicated that the cost of these screening options vary widely depending on the patient's insurance, ranging from $ 30 to $ 30. (19659002) In a written statement from Wednesday, the Cancer Action Network of the American Cancer Society, the non-partisan advocacy group of the American Cancer Society, said that consumers should understand what their individual insurance plan will be when they're 45 years old instead of 50 years old begin to screen.

"Consumers should also understand that there are many screening options, and they may find certain screening options more affordable than others, especially if they have pocket spending," the statement said.

America's health insurance plans spokeswoman Cathryn Donaldson said in a statement Wednesday, "Health plans include the most required screening, including mammograms and colonoscopies, often at no additional cost to the patient." Insurance providers consider available evidence, clinical guidelines, and recommendations from organizations such as the American Cancer Society to understand when checkups are required.

"Whether you need a check-up depends on your age, your medical history, and other risk factors. If a doctor recommends screening for such risk factors, this is usually covered, "said the association, which represents companies that provide health insurance coverage and other related services to Americans.

Out of the Cost and Frequency of a Test It is recommended that "all these tests are approximately equal in value and can be offered," said Wender.

"We know from studies that if you offer the choice between colonoscopy and a less invasive test, more people will become Decide to be checked as to what our ultimate goal is, "he said." The evidence is now absolutely clear, and I can not stress how carefully this was done. It took us two years of work to provide a convincing argument and proof that the screening age should begin for everyone aged 45 years and not over the age of 50 years.

What Declares the Increase in Colorectal Cancer?

The time will tell if other leaders health organizations follow in the footsteps of the American Cancer Society by recommending screening for adults under the age of 50.

In addition, more research could be done about it Dr. Colorectal Cancer Director at the MD Anderson Cancer Center, Houston, said he was not involved in the updated guidelines.

"The screening rate is below 50 years is negligible. Therefore, what we have observed in the rising incidence is not just a series of detection errors, "said Chang." This seems to be a real phenomenon. "

He added that he has some ideas of what factors could drive this increase because "there are a number of things that have changed over the past few decades, exposures and lifestyle. "

" We know that obesity is associated with an increased incidence of many cancers, including colon cancer, and the obesity epidemic, an important and growing problem in the US. This could be an associated factor, "Chang said.

Other possible factors could be sedentary lifestyles, environmental pressures, and diets high in processed foods, he said.

" Although we have not identified the causal factor, it is It's likely that all of these factors contribute to this rising incidence, "he said.

A separate report released last week by the World Cancer Research Fund and the American Institute for Cancer Research showed strong evidence of being physically active high-fiber foods and other healthy habits can reduce the risk of colorectal cancer

Consumption of red meat, processed meat and alcoholic beverages, among other factors, could increase the risk of colorectal cancer

For every adult Regardless of how old Chang said that it is important Be mindful of your body and bowel habits to keep track of your overall health – and that alarm is important to your doctor. [19659002] "Even if you are younger, if you notice that your bowel habits or bowel movements are changing and something is wrong, then consult your doctor," he said. "This is the public health statement that is looking out for your guts and seeking medical attention when things do not seem right, when blood in your chairs or your bowel habits suddenly change."

This gives us a real chance & # 39;

Dr. Nilofer Saba Azad, associate professor of oncology at Johns Hopkins Medicine in Baltimore, agrees with the recently updated guidelines.

"Taking into account that people get colon cancer and rectal cancer for many years and there is a step A smart progression from anomalies to polyps and then cancer development gives us a real chance to prevent people from ever getting cancer by making the screening age younger, "said Azad, who was not involved in the guidelines.

It's not just that you would catch the younger people with cancer, but that you would catch the younger people with just one polyp, which can be removed at the time of colonoscopy, and they never get cancer. So it's preventative, not just an early diagnosis, "she said, adding that she believes that the benefits of early detection outweigh the risks.

These risks include false negative or false positives, as well as rare complications or feelings of anxiety B with more invasive approaches such as colonoscopy

"However, there are many ways to screen for colon cancer, and we can find a way, no matter how squeamish people are," said Azad.


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