Why doctors say 45 is the new 50

Posted at 2:11 PM, Sep 09, 2021
and last updated 2021-09-09 16:11:19-04

A dramatic increase in colorectal cancer cases among young people has led the United States Preventive Services Task Force to establish new colon cancer screening guidelines.

Medical experts are now officially recommending that people with average risk have their first colonoscopy or other screening at age 45, rather than 50 which was the previous standard.

For several decades the survival rate of colorectal cancer has improved, but research indicates a higher trend of incidence of colorectal cancer and mortality in younger adults.

Richard Rogers, 41, was one of those statistics. The Taylorsville resident who is normally very active found in 2019 he couldn’t keep up with his friends playing basketball. He thought he was just anemic, but doctors diagnosed him with anemia and stage 3 colon cancer.

Surgeons removed 10 or 11 polyps and a tumor the size of a golf ball. After a round of chemotherapy, he says he now has a clean bill of health and reminds others to get tested and not ignore any symptoms.

“Pay attention to your body,” said Rogers. “The prep work for a colonoscopy may not be fun, but don’t be a wimp, just do it. It’s not that bad.”

Statistics and Facts:

  • About 11 percent of colorectal cancers are diagnosed in those younger than 50 years. Based on these findings the age for screening has been lowered to 45 for average-risk adults, according to the Colorectal Cancer Alliance.
  • Colorectal cancer is still a leading cause of cancer death for men and women. Each year, almost 53,000 people die in the United States and 145,000 Americans are diagnosed with colorectal cancer.
  • According to the American Cancer Society, 9 out of 10 times early treatment saves lives and the five-year survival rate for colon cancer if caught early is 90%.
  • Colorectal cancer is preventable, detectable and if found early, treatable.

Intermountain Healthcare clinicians are reminding people about the importance of regular screening in order to detect cancer at its earliest – and most treatable stage.

“Catching colon cancer can be tough when you don’t know you’re supposed to be looking – it’s not even on your radar,” said Mark A. Lewis, MD, a medical oncologist and director of gastrointestinal oncology at Intermountain Healthcare. “Early screening, especially with colonoscopy, holds the promise of saving lives.”

Many colorectal cancers begin as a small polyp, and if a polyp is found during colonoscopy, it can be removed, preventing the polyp from ever turning into cancer. Thus, colonoscopy can serve as both a screening AND preventive tool.

“Ask your doctor about screening if you or a closer relative has had colorectal polyps or colorectal cancer,” said Naresh Agarwal, MD, associate chief medical officer primary care at Intermountain Healthcare. “Understanding family history, genetics, and other risk factors can help patients and doctors determine when to screen. You just don’t have any time to waste.”

In the early stages of colorectal cancer, there may be no symptoms. This is another reason why it’s important to know the risk factors associated with colorectal cancer and talk to your doctor about scheduling a screening.

Risk Factors:

  • Family History – If you have a close relative who has had colon cancer or a colon polyp, you may be at higher risk for getting the disease.
  • Age – About 90% of the time, colorectal cancer occurs in adults older than 45.
  • Ethnicity – Rates of colorectal cancer are higher in African Americans compared with other races. This may be because fewer African Americans get screened for colon cancer.
  • Medical Conditions – Having an inflammatory bowel disease may increase your risk of developing colon cancer.
  • Lifestyle – There are some risk factors you can change. These include stopping smoking, improving your diet, being active, and keeping a healthy weight.

“Cancer doesn’t care who you are,” said Dr. Lewis. “Cancer used to be considered a disease of aging. It is not. Cancer has no respect for age or gender or race or creed.”
Screening for colon cancer:
In the past one of the only ways to screen was a colonoscopy, which uses a camera system inserted into the colon to look for possible issues. New advancements allow people to screen more often using a Fecal Immunochemical Test (FIT) kit at home.

The test isn’t set to replace a colonoscopy, but can serve as a vital tool for regular monitoring for those with low to moderate risk of colorectal cancer.

The test works by the patient using the kit to take a small sample of their stool and put it in a tube for shipping back to the central lab. Technicians then use antibodies to look for traces of blood that wouldn’t’ be visible to the human eye. If the test comes out positive it could be the early signs of a bigger issue such as colon cancer. A doctor would follow up about additional screenings that would be needed to find the problem.

If a patient has a positive test, FIT kits aren’t recommended for further use, and doctors say a colonoscopy would be the best prevention measure in the future. They also may have to be done more often depending on what a person’s doctor recommends.

A person can receive a FIT kit by having their doctor order them one. It is recommended people speak with their doctors to come up with a screening plan that’s right for them. Always call your insurance company before undergoing any test or procedure to determine coverage and any other questions you may have.

If you are 45 years old or older, talk to your doctor about which test is right for you. 45 is the new 50 - and it could save your life. For more information on FIT kits, colonoscopies, or to find a physician visit or go here.