Medical experts update guidelines for colorectal cancer, recommend screenings at age 45

INDIANAPOLIS (WISH) – The United States Preventive Services Task Force (USPSTF) updated its recommendation for when to get a colorectal cancer screening. The organization now says testing should begin at age 45, instead of 50. 

News 8 spoke with Dr. Paul Helft, who specializes in cancer, about the updated guidelines and what prompted the change. 

Gillis: We’re talking about a change in guidelines for a certain type of cancer in terms of screenings. What cancer are we talking about?

Helft: We’re talking about screening for colorectal cancer, which is one of the leading causes of cancer and leading causes of cancer mortality in this country. There are thousands of Americans who get colorectal cancer each year. 

Gillis: What do you think prompted this change in guidelines? We went from age 50 and now it’s down to 45. 

Helft: Over the past 30 years there has been accumulating evidence that younger and younger people are getting colorectal cancer. So, even though this used to be a disease primarily in people in their late 60’s or early 70’s, the age of the acquisition of the disease has been going down for the past 30 years. We’re seeing about a 50 percent rise in people who are younger. Up to a third of patients are under the age of 50. 

Gillis: Why do you think that is?

Helft: Well, there are several theories, but no one is absolutely certain about the reasons why. Some of it has to do with the larger trends in the population. Some of it probably has to do with diet and changes in dietary habits in the last few years. But nobody is really sure yet. 

Gillis: Lowering the guidelines will catch this cancer earlier and will save lives. But the change is not from the American Cancer Society. The American Cancer Society already had these guidelines…these have been their guidelines. It’s the U.S. Preventive Task Force. Explain the difference between the two organizations and why is the Task Force just now catching up to the American Cancer Society?

Helft: It’s a little unclear to me why the U.S. Preventive Task Force decided to release this information at this time. Two years agoP in 2018, specifically, they came out with a lowering of the average age from 50 to 45 because of this trend and the acquisition of this at earlier ages. So, I’m not sure why the U.S. Preventive Task Force is just now coming out with the recommendation. I agree with the recommendation. More and more I’m seeing patients in their 20’s and 30’s and 40’s and it’s likely if we lower the average age the cancer will be caught earlier and the earlier you find the colorectal cancer the more curable it is. 

Gillis: And your thoughts on different types of screenings. We can give samples. We can get a colonoscopy. And then how do we get people to comply with these recommendations. 

Helft: Yes. So, this has been a big problem from a public health perspective because around 60% of people over 50 are screened for colorectal cancer as per the guidelines. That leaves nearly half of the population over the age of 50 not getting screened. There are many complex reasons. Many people make a choice that they are not comfortable with with screening. And now we have people at the age of 45. At the very least these people should have stool samples. That’s a common way that is detected. There are many stool tests and then the colonoscopy, which is the gold standard in terms of testing.