A medical task force is following the lead of the American Cancer Society by recommending that screening for colon cancer and rectal cancer begin at age 45 — five years earlier than current practices.
The U.S. Preventive Services Task Force released its proposal last week, marking a significant change from its position five years ago. In 2015, it said that because data was mixed on lowering the starting age for the cancer tests, beginning the screens at age 45 would only provide modest benefits.
An official with the American Cancer Society, which lowered its screening recommendation to age 45 in 2018, said the task force’s change is likely to expand the number of younger patients getting the cancer test because health insurers will be required by law to cover the full cost of the procedure for anyone 45 or older.
What’s most interesting about this news is the fact that colon and rectal cancer rates for people younger than 45 have been rising in recent years. A prominent example is “Black Panther” actor Chadwick Boseman, who died of colon cancer this year at age 43.
A 2017 story in The Washington Post reported that rates of colon cancer and rectal cancer were rising sharply for people in their 20s and 30s. Rates for people 55 and older have continued a four-decade-long decrease, which most likely is due to relatively high rates of testing, such as the colonoscopy procedure.
The 2017 story said that between the mid-1980s and 2013, colon cancer rates increased 1% to 2% annually for people in their 20s and 30s. Rectal cancer rates increased even more rapidly: 3% per year for those in their 20s and 30s, and 2% per year for ages 40-54.
The big question, of course, is why these cancer rates are rising among younger adults. There are suspicions — changing diets, lower fiber consumption, sedentary lifestyle, weight gain — but nothing has been verified.
The American Cancer Society reported this year that rising cancer rates among younger white people appear to be driving the trend. But Black people have traditionally had a high rate of colon cancer, which medical specialists believe is largely due to less access to care.
Testing for colon cancer and rectal cancer makes many people uncomfortable. The main exam is the colonoscopy, which includes the joyless procedure of cleansing the large intestine the night before, and then being anesthetized while a doctor uses a long tube to look for unusual growths in the colon.
The good news is that if a growth, called a polyp, starts developing in your colon, it may be years before it becomes cancerous, if ever. There is plenty of time — up to a decade — for a doctor to find it and remove it.
Reluctance to undergo such invasive testing is understandable. But this is contributing to a large number of deaths from colon cancer or rectal cancer. Boseman, the actor, was one of about 50,000 people who died from colon or rectal cancer this year. These combine to create the third leading cause of cancer deaths.
Starting the cancer screens at age 45 is a good idea. The concern is that if present trends continue, the age may need to be reduced again.