A U.S. study on colorectal cancer suggests earlier screening for younger adults
Photo by loly galina on Unsplash
Written by Jeffrey L. Axler, MD, FRCP(C). Edited by Tania Haas
The January 2016 study published in the medical journal Cancer found that one in seven, or 14 percent, of colon and rectal cancers in the U.S. are diagnosed in patients younger than the age of 50. That’s the age when most Americans (and Canadians) are advised to begin routine screenings. The authors of the study suggested U.S. adults may want to consider screening earlier. Critics of the study said the yield of screening will be low since young people are less likely to get colorectal cancer than older people.
At the end of the day, it’s all about choice. You are in control of your own health and you have the option to get screened when it is right for you.
Canadians and colorectal cancer
Colorectal cancer is the third most commonly diagnosed cancer in Canada, the second leading cause of cancer death in men, and the third in women.
The good news: colorectal cancer is one of the most responsive cancers to early treatment, with a five-year survival rate of 90 percent. Even better, when a polyp is detected early (a polyp is the small growth on the lining of colon or rectum), your medical team can stop the cancer before it starts.
Younger Canadians and colon cancer
In Ontario, 8.8 percent of all male colorectal cancer cases occur in men under age 50. The statistics are similar for Ontario women. Individuals in these age groups are generally not eligible for provincially-funded screening unless they have symptoms or have an affected first degree relative. This is interesting since U.S. screening guidelines start at age 45 for certain high-risk groups. These groups have lower cancer rates than certain populations in Ontario, even though the province’s screening guidelines* remain at 50.
Medcan respectfully maintains its position as a destination for early cancer detection with colonoscopies for individuals above and below age 50.
How to conquer your colonoscopy
Here are a few tips to help you prepare for the experience:
Better prep, better visibility for your doctor. This means there is a better chance you will find something, if there is something to be found.
No need to overdo the laxatives. The quantity of laxatives has decreased significantly in recent years: only three 5 ounce servings.
They are more tolerable now, too. Most clients don’t find the taste to be unpleasant. Sucking on a hard candy or rinsing with mouthwash can also make it more palatable.
You can drink a beer. You’ll have to drink at least two liters of clear liquid while taking the laxatives like apple juice, sports drinks or any drink you can see through (that’s not red). If you’d like to enjoy a beer or glass of white wine, that’s okay. But one is enough as the prep will dehydrate you.
Your nurse loves to talk polyps. We welcome all sorts of questions as you prepare ahead of the procedure.
*New guidelines, do they apply to you?
The screening guidelines for Canadians under the age of 50 with a family history (first degree relative) is every five years, with initial screening recommended 10 years prior to the age the first degree relative was diagnosed.
The updated guidelines released last month in the Canadian Medical Association Journal apply to adults ages 50 to 74 and recommend patients undergo fecal occult blood testing (FOBT) every two years, or a flexible sigmoidoscopy every 10 years (this procedure reviews only the lower portion of the colon and rectum, whereas a colonoscopy reviews the entire colon).
Outlook: DNA technology
We are monitoring the development of emerging technologies, including non-invasive colon cancer screening tests based on stool DNA, which may address the inconsistencies and unreliability of the FOBT. At this time, in terms of prevention, a colonoscopy remains the gold standard for all ages.
Jeffrey L. Axler, MD, FRCP(C) is the Director of Gastroenterology and Endoscopy.
Studies ReferencedAbdelsattar, Zaid M., Sandra L. Wong, Scott E. Regenbogen, Diana M. Jomaa, Karin M. Hardiman and Samantha Hendren. Jan 25, 2016. “Colorectal cancer outcomes and treatment patterns in patients too young for average-risk screening.” CANCER, Vol. 122, Issue 6, 929–934.
Canadian Task Force on Preventive Health Care. Feb 22, 2016. “Recommendations on screening for colorectal cancer in primary care.” Canadian Medical Association Journal, Vol. 188, No. 5, 340-348.