Don’t turn the other cheek!
Colorectal cancer is one of the most common and deadliest cancers worldwide — it’s expected to cause nearly 53,000 deaths in the US this year. And it’s rising among younger adults, a concerning trend that’s perplexing scientists.
While they can be a pain in the butt, early detection and preventative measures are critical because they can significantly improve survival rates and treatment outcomes. The US Preventive Services Task Force (USPSTF) generally recommends that adults aged 45 to 75 be screened for colorectal cancer.
It may be more beneficial to start earlier. A new study out of Taiwan found that beginning colorectal cancer screening at 40 can reduce cases by 21% and deaths by 39% compared to starting screening at 50.
“These results provide strong empirical support for lowering the [colorectal cancer] screening age, with substantial public health implications,” the researchers wrote this week in the journal JAMA Oncology.
This study relied on fecal immunochemical tests (FITs) — non-invasive, at-home exams that detect blood in poop, which may indicate abnormal growths in the colon or rectum.
Nearly 40,000 people in their 40s participated in early and continuous screening for the study, while about 225,000 people in their 50s only underwent regular screening.
There were 26.1 cases of colorectal cancer per 100,000 person-years in the younger group, compared to 42.6 cases in the older group.
“Whether early screening policies are generalizable to other populations should be evaluated carefully,” the researchers wrote.
“Given our findings and recent studies supporting screening from age 45 years, further international research is warranted to guide global health policies on early [colorectal cancer] screening.”
Colorectal cancer is the second most common cancer in Taiwan.
Just this year, the nation expanded its screening program to allow people 45 to 74 years old to FIT screen for free every two years.
The minimum age used to be 50. Those who are 40 to 44 can participate in the program if they have a family history of colorectal cancer.
In the US, the USPSTF lowered its recommendation for starting colorectal cancer screening from age 50 to 45 in 2021.
The task force recommends FITs as a screening method that should be done annually.
Other options include colonoscopy (a tube with a camera examines the rectum and colon), CT colonography (X-rays and a computer visualize the colon and rectum) and flexible sigmoidoscopy, a less invasive alternative to a colonoscopy.
Those with a family history of colorectal cancer may have to start screening earlier and get screened more often.
Medicare Part B covers annual FIT screenings for people 45 and older. The minimum age was lowered from 50 to 45 in 2023.
If the FIT test result is positive, Medicare covers a follow-up colonoscopy.
