Colorectal cancer remains one of the most common and deadly cancers globally. Alarmingly, cases are on the rise among younger adults, a trend that continues to puzzle medical professionals. Experts project nearly 53,000 deaths from this disease in the US this year alone.
Despite its prevalence, colorectal cancer is often highly treatable, especially when detected early. Preventative measures and timely screening are absolutely crucial for improving survival rates and treatment outcomes.
Current Screening Guidelines and New Research
In the United States, the U.S. Preventive Services Task Force (USPSTF) currently recommends that adults aged 45 to 75 undergo screening for colorectal cancer. This guideline was updated in 2021, lowering the recommended starting age from 50 to 45.
However, new research suggests that starting screening even earlier could offer significant benefits. A recent study conducted in Taiwan, published in the journal JAMA Oncology, found that beginning colorectal cancer screening at age 40 could reduce cases by 21% and deaths by an impressive 39% compared to starting screening at age 50.
Researchers involved in the study stated that “These results provide strong empirical support for lowering the [colorectal cancer] screening age, with substantial public health implications.”
How the Study Was Conducted
The Taiwan study utilized Fecal Immunochemical Tests (FITs). These are simple, noninvasive, at-home tests that detect hidden blood in stool samples, which can be an early sign of abnormal growths in the colon or rectum.
The research involved nearly 40,000 individuals in their 40s who participated in early and continuous screening. Their outcomes were compared to approximately 225,000 people in their 50s who underwent standard, later screening. The data showed a notably lower incidence rate in the younger screening group: 26.1 cases per 100,000 person-years compared to 42.6 cases in the older group.
While acknowledging the need to evaluate if these findings are applicable to other populations, the researchers emphasized the strength of their results and called for further international research to help guide global health policies on early colorectal cancer screening, especially in light of recent studies supporting screening from age 45.
Taiwan recently expanded its national screening program, now offering free FIT screening every two years for individuals aged 45 to 74. Those aged 40 to 44 can participate if they have a family history of colorectal cancer.
Understanding Colorectal Cancer Screening Methods
The FIT test used in the Taiwan study is just one of several effective screening methods available. The USPSTF recommends annual FIT tests as a screening option in the US.
Other common and recommended screening methods include:
Colonoscopy: Considered the gold standard, this procedure involves a doctor using a flexible tube with a camera (endoscope) to visually examine the entire colon and rectum. It allows for the detection and removal of polyps during the same procedure.
CT Colonography (Virtual Colonoscopy): This method uses specialized X-ray equipment and a computer to create detailed images of the colon and rectum.
- Flexible Sigmoidoscopy: Similar to a colonoscopy, but it only examines the lower part of the colon (sigmoid colon and rectum). It’s less invasive than a full colonoscopy but doesn’t screen the entire colon.
Individuals with a family history of colorectal cancer or certain genetic conditions may need to begin screening at an earlier age than guidelines suggest and may require more frequent screening.
Medicare Coverage
For individuals aged 45 and older, Medicare Part B covers annual FIT screenings. If a FIT test returns a positive result, Medicare also covers a follow-up colonoscopy. The minimum age for Medicare coverage of FIT tests was lowered from 50 to 45 in 2023, aligning with the updated USPSTF guidelines.
What This Means For You
The new research from Taiwan adds to the growing evidence supporting the benefits of earlier colorectal cancer screening. While current US guidelines recommend starting at age 45, this study suggests that starting even sooner, potentially at age 40, could lead to a significant reduction in both cases and deaths.
Talking to your healthcare provider is the best way to determine the right screening schedule and method for you based on your age, family history, and individual risk factors. Don’t delay this critical step in protecting your health.
