American Cancer Society: Start Colorectal Cancer Screenings at Age 45, Not 50

The American Cancer Society (ACS) is urging people to start having colorectal cancer screenings at age 45, not 50, as previously advised. [1]

Colorectal cancer is the 4th-most diagnosed cancer, and the 2nd leading cause of cancer deaths in the United States.

In the past, adults were advised to undergo screenings starting at age 50 to catch slow-growing malignancies. But in a paper published by the ACS on May 30, the group said that screenings should start 5 years sooner.

Dr. Richard Wender of the ACS said:

“There is compelling evidence that the optimum age to start is now 45. People born in the eighties and nineties are at higher risk of developing colon cancer, particularly rectal cancer, than people born when I was born back in the fifties. We just have to face reality. We just don’t know why it’s increasing.”

Wender noted that there has been a sharp increase in the number of deaths caused by cancers of the colon and rectum in adults under 50.

The U.S. Preventative Services Task Force and other groups continue to recommend age 50 as the best time to start getting screenings.

According to Dr. Robin Mendelsohn of New York City’s Memorial Sloan Kettering Cancer Center, her hospital has seen 4,000 new cases of colorectal cancer in patients under 50 in the last decade, and the majority of them don’t have any of the traditional risk factors, such as obesity, smoking, physical inactivity, or high-fat diets.

Read: Colorectal Cancer is Widespread in Parts of the South

Disturbingly, many of them are remarkably healthy individuals. In many cases, according to Mendelsohn, their doctors told them they were “too young” to have cancer.

“[Some] are marathon runners who don’t eat red meat, don’t smoke, do everything right and say ‘Why did this happen to me?’”

A Rise Due to Improved Screenings? Maybe, Maybe Not.

Part of the uptick in diagnoses could be the result of improved screenings, the organization explained. If so, that would be a positive thing, as it means doctors are catching more cancer cases before they have a chance to become untreatable.

However, there is likely more to the story. The risk of developing colon cancer is twice as high as it was years ago, and the risk of developing rectal cancer is 5 times higher, according to Wender. [2]

There has been an increase in obesity in the U.S. Consider the following data from the U.S. Centers for Disease Control (CDC), published in a report titled “Obesity Trends Among U.S. Adults Between 1985 and 2010”:

  • In 1990, among states that participated in the Behavioral Risk Factor Surveillance System, 10 states had a prevalence of obesity less than 10% and no states had prevalence equal to or greater than 15%. [3]
  • By 2000, no state had a prevalence of obesity less than 10%, 23 states had a prevalence between 20%-24%, and no state had prevalence equal to or greater than 25%.
  • By 2010, no state had a prevalence of obesity less than 20%. Thirty-six states had a prevalence equal to or greater than 25%; 12 of these states (Alabama, Arkansas, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Oklahoma, South Carolina, Tennessee, Texas, and West Virginia) had a prevalence equal to or greater than 30%.

Wender said that “we don’t think that explains the entire change. There is a great deal of interest and a lot of research beginning to try to answer that question.” [2]

Some of the other culprits researchers are investigating include over-the-counter anti-inflammatory drugs, antibiotics, and antidepressants, in addition to multiple vitamins, probiotics, and other dietary supplements.

Read: Overuse of Antibiotics Linked to Precancerous Colon Polyps

In the report, the ACS said the best methods for colorectal cancer screenings are colonoscopies, visual tests, and a high-sensitivity stool-based test. In addition, the organization said it categorized screenings for adults ages 45-50 as a “qualified recommendation,” while tests for people over 50 are categorized as a “strong recommendation.” [1]

The good news is that the rates of colorectal cancer deaths have been falling for decades, thanks, in part, to better screening and treatment methods. [4]

However, this year an estimated 140,000 Americans are expected to be diagnosed with colorectal cancer, and about 50,000 may die from it.


[1] UPI

[2] NPR

[3] U.S. Centers for Disease Control and Prevention

[4] CBS News

Living in the Country Reduces Risk of Dying from Cancer by 29%

Living in a rural area has a multitude of benefits – cleaner air, less noise, and more relaxing surroundings, just to name a few. If you’re fighting cancer from a rural area of the country, your location may also boost your odds of survival quite significantly, research shows (though it may be because of the type of general practitioners (GPs) you’re more likely to find in the country).

Let’s not knock city livin.’ There are lots of awesome things about living in a big city, but it can be a much more stressful environment than rural and even suburban environments. Air pollution – a major problem in cities – has been linked to greater breast density, which is a precursor to breast cancer. Even the constant sound of vehicles passing by has been associated with weight-gain.

It also takes longer to make a doctor’s appointment, and you might not get as much TLC from an urban GP as you would from a rural one.

Source: EPA

Researchers at the University of Aberdeen studied 926 Scottish patients with bowel cancer, using a database linking GP records to routine data for patients diagnosed with bowel cancer between 1997 and 1998. The researchers followed the patients up to 2011.

They found that cancer patients who lived in rural areas were 29% less likely to die from the disease than those who lived in cities. Lead researcher Peter Murchie called the findings “very reassuring for rural populations.” [1]

By the time rural cancer patients seek medical attention, their symptoms are often more serious, compared to those of urban patients. However, that doesn’t mean their illness is more advanced, Murchie and his colleagues discovered. In this particular study, waiting longer did not seem to limit cancer patients’ chances of survival.

Murchie said:

“[This] fits with ideas of rural stoicism and patients taking longer to react and waiting. They present with more serious symptoms, but there isn’t good evidence that they have more advanced disease.” [1]

People who live in the country are more likely to have a relationship with their doctor, and that appears to be one of the main survival-boosting aspects of rural living, Murchie explained.

If you’re an urban dweller and see a city slicker doctor, you can probably attest to the unfortunate reality that many urban practices are about as personable as a cattle call. And in densely populated areas, being physically closer to a hospital isn’t necessarily “better” if you have to wait months to schedule an appointment.

Source: The Washington Post

Another potential reason for the increased cancer survival may be wealth. Rural patients tend to be more affluent than those in deprived urban areas. Another factor may be the more traditional nature of rural GP surgeries, said Murchie. [2]

“The nature of your relationship with your GP is different in rural areas… You’re more likely to know the GP socially and that can help or hinder depending on symptoms. Access to rural GPs, generally speaking, is easier than it would be if you registered at a big urban practice.” [1]

Helen Stokes-Lampard, chairwoman of the Royal College of GPs in the U.K., said:

“It’s encouraging that this study demonstrates GPs and our teams in remote and rural areas are overcoming the specific challenges facing them, and delivering good cancer care. This should reassure patients who live in remote areas, and/or have longer travelling times to their local GP practice, that the quality of care that they receive is not affected.” [2]


[1] Net Doctor

[2] The Times of London


The Washington Post

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