Detection of colon cancer should start at 45: American doctors

Cancer: histopathological image of colonic carcinoid. Credit: Wikipedia / CC BY-SA 3.0

Screening for colon cancer should start earlier, at age 45 instead of age 50, because of an increase in colorectal tumors among younger people, the American Cancer Society said on Wednesday.

The new guidelines came after research showed a 51 percent increase in colorectal cancer among people under 50 since 1994, and an increase in death rates.

"When we started this guide update, we initially focused on whether screening should begin earlier in racial subgroups with a higher incidence of colorectal cancer, which some organizations already recommend," said Richard Wender, chief of cancer control at the National Cancer Institute. American Cancer Society.

Groups that suffer disproportionately high rates of colon cancer include African-Americans, Alaska Natives, and Native Americans.

"But as we saw data pointing to a persistent tendency to increase the incidence of colorectal cancer in younger adults, including research from the American Cancer Society that indicated that this effect would be prolonged with age, we decided to rebadess age to initiate screening in all US adults. "

The new guidelines do not specify what kind of test is obtained, but it includes options such as a traditional colonoscopy, which must be done every 10 years, or stool badysis. high sensitivity that, depending on the type, can be done every year or every three years.

Regular screening should continue for up to 75 years, and "doctors should discourage people older than 85 years from continuing colorectal cancer screening" because the risk of complications outweighs the benefits at that age, the report said. .

Mysterious cancer increase

Experts say it is not clear why colon cancer rates are rising in younger people.

Research shows that adults born around 1990 have double the risk of colon cancer and four times more risk of rectal cancer than adults born around 1950, who have the lowest risk, said the report in CA : A Cancer Journal for Clinicians, a peer-reviewed journal of the American Cancer Society.

Meanwhile, rates of colon cancer in people older than 55 years are declining, largely due to energetization and removal of precancerous polyps.

According to Elena Ivanina, gastroenterologist at Lenox Hill Hospital in New York, the 51 percent increase in colorectal cancer among those under 50 since 1994 is an "alarming" trend.

"The reason for the increase is currently unknown, but possibly badociated with obesity and sedentary lifestyles, excessive alcohol consumption and chronic inflammatory conditions, which are on the rise," said Ivanina, who did not participate in the development of the guidelines.

applauded the progress towards an earlier evaluation, saying that "it will benefit the general public".

Another widely respected medical group that issues screening recommendations, the United States Preventive Services Working Group (USPSTF), decided not to recommend in 2016 that colon cancer screening starts at 45, and says any Additional benefit would be "modest".

The American Cancer Society urged people to talk with their doctors about what kind of screening "I would say a real colonoscopy would be the best for multiple reasons," David Bernstein, chief of hepatology at Northwell Health in New York, He said: told AFP.

"It's the only one of those tests that really prevents cancer, it allows you to find polyps before they turn into cancer."

Explore more:
The American Cancer Society updates the colorectal cancer screening guide

More information:
Andrew M. D. Wolf et al. Screening for colorectal cancer for adults at average risk: update of guide 2018 of the American Cancer Society, CA: A Cancer Journal for Clinicians (2018). DOI: 10.3322 / caac.21457

© 2018 AFP

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