45 Is the New 50 for Colorectal Cancer Screening February 28, 2023 It’s been nearly two years since the U.S. Preventive Services Task Force changed the age recommendation for colorectal cancer screening from age 50 to 45. Yet, many who are aging into 45 may not have this life-saving screening on their radar. What you may not realize, colorectal cancer is the third leading cause of cancer-related deaths in the United States – with an expected death total of 52,550 in 2023 alone. When caught early, it is also one of the most treatable. Screening Saves Lives The American Cancer Society estimates there will be 153,020 new cases of colorectal cancer (cancers of the colon or rectum) in the U.S. in 2023. If caught early, survival rates are 91%. A colonoscopy, one of several screening options for colorectal cancer, is recommended for most people starting at age 45. It allows surgeons to search the colon for polyps, the first indicator of cancer. Typically, polyps start small. As they grow, cells can change to become cancerous. That is why early detection is best. A colonoscopy allows the physician to see the entire colon, and if a polyp is found, it can be removed right then. A colonoscopy is considered a low-risk outpatient procedure, but like most medical tests, can prompt anxiety. It’s important to talk with your doctor about questions or concerns you may have. What to Expect When You Schedule a Colonoscopy? Preparation for a colonoscopy is usually the most unpleasant aspect of the test. Patients are expected to drink clear liquids and a medication that completely empties the colon, and for some, this may be uncomfortable. Once in the procedure room, the screening generally takes less than an hour. A long, flexible instrument called a colonoscope is inserted into the rectum and advanced through the colon and large intestine. A tiny camera and light on the end of the colonoscope allow the physician to visually inspect the colon on a digital monitor. Pictures can also be taken for future comparison and small tissue samples are occasionally removed for biopsy. A patient can be awake, but most choose to be mildly sedated. If there are no polyps, and no family history of colon cancer, a repeat test isn’t needed for 10 years. If polyps are precancerous or cancerous your physician will recommend an earlier repeat colonoscopy and potentially other treatment, depending on polyp size and type. Additional Colon Screening Other screening options include: stool tests – a sample is often collected yearly and tested in a lab (not often recommended), flexible sigmoidoscopy – similar to a colonoscopy, but a shorter scope is used (recommended every 5 years, and in combination with a stool test) or a CT colonography – uses computer images of the entire colon, which are then examined by a physician (recommended every 5 years). If polyps are discovered using any of these alternate screening options, a complete colonoscopy is recommended. Early detection truly matters! Talk with your primary care provider about which screening option may be right for you, especially if you have any family history of colon cancer. Sushanth Kakarla, MD, is a medical oncologist with Samaritan Hematology & Oncology Consultants. Dr. Kakarla sees patients with all types of cancer and blood disorders and has a special interest in colorectal cancer. Building Awareness Together Hear from Vallie Gibby, and how a screening helped with early detection of colorectal cancer.