The American Cancer Society is recommending that people at average risk of colorectal cancer start regular screening at age 45 rather than at 50, at a time when studies show a rise in cases of the disease among younger individuals.
While few trials have looked at screening 45-year-olds, new statistical models reviewed by the cancer society showed that the younger group should benefit almost as much as slightly older adults do, Wolf said.
Colorectal cancer is the second-leading cause of cancer death in the United States, most frequently diagnosed among adults over 65.
Weinstein noted that Cologuard is now approved for colon cancer screening for people between the ages of 50 and 84, adding that the company would need to run a separate trial for lower age groups.
But while incidence and deaths among those 55 and older have been declining in recent decades, at least in part because of screening that results in removal of precancerous polyps and early detection of cancer, recent analyses have documented a 50 percent rise in colorectal cancer rates among adults under 50 between 1994 and 2014.
Recommended options for colorectal cancer screening include: fecal immunochemical test (FIT) annually; high sensitivity guaiac-based fecal occult blood test (HSgFOBT) annually; multi-target stool DNA test (mt-sDNA) every 3 years; colonoscopy every 10 years; CT colonography (CTC) every 5 years; and flexible sigmoidoscopy (FS) every 5 years.
For colorectal cancer, the American Cancer Society didn't push one screening option over another but listed various options: High-sensitivity stool tests, created to detect blood in feces, which need to be administered every year; a DNA stool test, sold under the brand name Cologuard, every three years; a colonoscopy, every 10 years; or a virtual colonoscopy or flexible sigmoidoscopy, every five years.
A first colon cancer screening does not have to be a colonoscopy.
Experts say this is one of the few cancers that can be prevented with screening.
The unexpected problem: Younger adults.
The American Cancer Society says it endorsed the full range of screening tests "without preference" in order to improve the rate of screening.
The Colorectal Cancer Alliance established the Never Too Young Advisory Board so we may all join forces and take action around the issue of young-onset colorectal cancer.
"While we have not identified the causal factor, it is likely that all of these factors contribute to this rising incidence", he said. They do, however, advise earlier screening for certain people at heightened risk - such as those with a strong family history of the disease.
For any adult, no matter how old, Chang said that paying attention to your body and bowel habits are important for tracking your overall health - and that alerting your doctor to any changes is key.
Breedlove said she's heartened by the change but believes the guideline should go even lower.
Dr. Nilofer Saba Azad, associate professor of oncology at Johns Hopkins Medicine in Baltimore, agrees with the newly updated guidelines.
Over the last 10 years, Memorial Sloan Kettering has seen 4,000 new colorectal cancer patients under age 50, she says.
The younger start data for colorectal cancer screening puts the ACS at odds with the U. S. Preventive Services Task Force (USPSTF), which stayed with its recommendation of initial screening at age 50 in an update published in 2016.
"It's hard enough to get people to do it at all", Plescia noted. "So it's preventative, not just early diagnosis", she said, adding that she thinks the risks of screening younger outweigh the benefits.