At what age should colorectal cancer screening begin?

Article written by Master, Doctor Mai Vien Phuong - Gastroenterologist - Department of Medical Examination & Internal Medicine - Vinmec Central Park International General Hospital.

A new study recommends starting colorectal cancer screening at age 45. That's because more and more cases of colorectal cancer in young people, researchers say.

Studies have identified more than 130,000 patients diagnosed with colorectal cancer under the age of 50. More than 1 million patients were diagnosed at age 50 or older. In those diagnosed under the age of 50, the number of cases between 2004 and 2015 increased.
Of all cases of colorectal cancer diagnosed, 10% were under the age of 50 in 2004. That number increased to 12.2 percent in 2015. At the time of initial diagnosis, patients were young. age are in more advanced stages of the disease - more than 50% have progressed to stage 3 or 4.
Among those diagnosed under age 50, the prevalence is higher in African-Americans (13.9% ) and Hispanic (18.9%).
A 2014 study published in the journal JAMA Surgery predicts that by 2030, the number of colon cancer cases in people aged 20 to 34 will increase by 90% and rectal cancer will increase by 124.2 percent.
Colorectal cancer is the third leading cause of cancer-related deaths in the US affecting both men and women, according to the Centers for Disease Control and Prevention. Even so, overall rates of new cancer diagnoses and cancer deaths across all ages have been steadily declining since 2009. Experts believe this is due to advances in screening and disease management.
Dr. Nancy You, associate professor of oncology surgery at the University of Texas MD Anderson Cancer Center, said that there are a number of factors contributing to the aforementioned reduction. “These are encouraging progressive trends and they reflect the collective achievements of our society as a whole. Previous modeling studies have shown that there are three main contributors: Advances in treatment, identification and modification of risk factors, and cancer screening practices.

There is disagreement among medical organizations about when to begin screening for colorectal cancer. The American College of Physicians recommends regular screening at age 50. However, the American Cancer Society has recommended starting screening at age 45 (as of 2018).
“This recommendation is based on a complex model created by Stanford Medical School; It is estimated that changing to screening at age 45 will save two lives out of every 1,000,” said Dr. Timothy Cannon at the Inova Schar Cancer Institute. "Although the incidence of colorectal cancer is generally quite stable, it occurs more frequently in young people and I think screening before age 50 is the right thing to do."
Experts say the incidence of colon cancer over the age of 50 has dropped due to screening colonoscopies, but screening those under 45 will cost more.

That boom could increase with more and more early-stage colorectal cancers being detected (5 times more) in people under 50 years old, says Dr. Anton Bilchik, an oncology surgeon , head of gastrointestinal research and chief medical officer at the John Wayne Cancer Institute at Providence Saint John Medical Center in California.
Bilchik points out that the growing obesity rate among Americans could be a culprit. "Obesity is one of the risk factors for colon cancer," he said. It's starting to show evidence of childhood obesity, so more attention needs to be paid to diet and exercise at an early age."
But the reasons for this increased cancer risk may be complex. More complicated than that, says Dr. Cannon, who said: "Obesity and sedentary lifestyle are the most common reasons but this doesn't seem to match my observations. I saw two track and field athletes under the age of 40 develop colon cancer during their training.A number of possible environmental causes and I suspect that some of these could be. related to a changing microbiome.”

Regardless of the cause, the experts say, this evidence suggests colorectal cancer screening at a younger age.
Dr. Bilchik said: “The public needs to know that the increase in young people being diagnosed with colorectal cancer is higher than for any other type of cancer. And most colorectal cancers are preventable with early screening.”
We need to educate adults about the preventable nature of this disease and the importance of early screening. Adults should know that the slow progression from precancerous polyps to invasive cancers creates a favorable opportunity for prevention and early detection. Screening should be considered a procedure that can prevent cancer through detection and removal of precancerous polyps/lesions and can detect cancer in its early stages, which would normally treat successful treatment.
Colorectal cancer is completely curable if detected early, so screening for early detection of colorectal cancer is very important. When there are risk factors or suspicious symptoms, you should go to hospitals and specialized medical centers for screening to help detect colorectal cancer early.
Vinmec International General Hospital is a large hospital chain, the first general hospital in Vietnam to meet global medical standards. Currently, Vinmec is a leading medical facility in the field of colorectal cancer screening and detection.
Vinmec International General Hospital is one of the hospitals that ensures modern equipment, a team of doctors, good and experienced staff with professors, doctors at home and abroad, and a disease prevention system. , the advanced test enables the implementation of the most advanced colorectal cancer screening techniques.