Colon cancer screening should start at 50, says American College of Physicians
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(CBS News) A new guidance statement from the American College of Physicians states what a lot of American adults may already know: They should get screened for colon cancer once they get older to reduce their risk of dying from the nation's number two cancer killer.
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"Only about 60 percent of American adults aged 50 and older get screened, even though the effectiveness of colorectal cancer screening in reducing deaths is supported by the available evidence," Dr. Virginia L. Hood, president of American College of Physicians, said in a written statement.
The College's new guidance statement includes recommendations from guidelines developed by other medical societies. According to the ACP, most adults should get screened for colon cancer beginning at age 50. People with a family history of colon cancer and others considered high-risk should get screened starting at age 40, or 10 years younger than the age of when your youngest family member was diagnosed with colon cancer. Other risk factors for colon cancer include age, race - African Americans have highest rates in U.S. - history of polyps or inflammatory bowel disease.
A colonoscopy is considered the "gold standard" of screening tools, according to the College. During the 30-minute procedure, a thin, flexible tube with a tiny camera is guided through the large intestine to look for precancerous growths called polyps so they can be removed before they turn into cancer. The new guidance recommends people should get a colonoscopy once every 10 years. For those who want other options, there is a stool blood test the College recommends people get annually, or a flexible sigmoidoscopy - a thin camera tube that's inserted that looks at the lower parts of the colon - that people should get every five years.
"We encourage patients to engage in shared decision making with their physician when selecting a colorectal cancer screening test so that they understand the benefits and harms," Hood said in the statement. "The success of any screening program, especially colorectal cancer screening, is dependent on the appropriate testing and follow-up of patients with abnormal screening results as well as following up with patients for repeat testing at designated intervals."
The College does not recommend continued screening for adults over 75 because the harms - such as the need for biopsies if something is found - would outweigh the benefits at that age because the cancers may be too slow-growing to ever cause a problem. The College's position statement is available online in the March 6 issue of Annals of Internal Medicine.
Colon cancer is expected to take more than 51,000 American lives this year, second to only lung cancer. A recent study says the procedure actually saves lives. It found people who got a colonoscopy were 53 less likely to die from colon cancer than people who weren't screened, HealthPop reported.
"There's no question that these are findings that we can take to the bank," Robert Smith, director of screening at the American Cancer Society, said at the time.
March is National Colorectal Cancer Awareness Month. Find out more about screening from the CDC.
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We accept the current guidelines for screening risk factors and intervals; however it is time to improve the current communication strategy. The reality is that the average age at which most people get their first screening colonoscopy is 57 - and that is disheartening.
We believe the first conversation about the entire topic - risks, symptoms and the topic of screening - should begin at 40.
By focusing the initial conversation on 50 rather than 40, we inadvertently miss opportunities to increase appropriate, effective and timely screening and early evaluation of symptoms.
By starting the conversation an decade earlier we can:
1. Identify and refer people who need screening tests at an earlier age, usually 40 years old. At least 20% of the adult population falls into this category. Family histories also change requiring a reassessment of screening needs.
2. Review the topic of colon cancer including the warning signs. Colon polyps and colon cancer both begin to rise measurably in the 4th decade. Focusing on 50 leads many to mistakenly attribute the warning signs of colon cancer to hemmoriods, irritable bowel syndrome or stress. People who develop signs and symptoms will be more likely to seek timely evaluation.
3. Put the power of marketing and communication to work. Be assured colonoscopy and colon cancer screening are still hard sells. By engaging in early discussion, the topic, the test and the actual execution will no longer be a dread or a taboo by the time a patient reaches the age of 50. By all the laws of marketing and communication, this should result in improved compliance at age 50 for those with average risk and no symptoms.
Starting the conversation upstream from the conventional age of the first screening will guarantee a higher percentage of patients are accurately and effectively screened now and in the future while completely following and supporting the current screening and surveillance guidelines. That is a true win-win in the fight against colon cancer.
Respectfully submitted,
Andrea Uhde Shepherd, Executive Director of the Colon Cancer Prevention Project
Whitney F Jones, MD, Founder of the Colon Cancer Prevention Project
coloncancerpreventionproject.org
Case closed!
BY FAR, the most important factor in preventing colorectal cancer diagnosis is vitamin D, at healthy blood levels.
Maintaining healthy levels (50-70 ng/ml) reduces colorectal cancer diagnosis.
End of story!
I can hardly wait. :-(
The biggest part of the deal was the prep kit (fleets enema
You , sir or madam, remind me of a woman who was horrified at a public seminar by a colonoscopy speicalist. I guess if she wants to take a chance on dying thats her own foolish business.
BTW both an Aunt and an Uncle, but not blood relatives, died of colon cancer in the 1970s.
And yes the doc showed me parts of the video tape they make when the do the colonoscopy.
Again, it was no big deal, they knocked me out, did it, a a couple hours later I walked out and went home, the only restriction - pls dont drive today.