Jennifer Lovejoy, Arivale Chief Science Officer, PhD
[Arivale Hot Topics address health stories currently in the news. The Arivale Clinical Team’s commentary on these news articles is not a review of the scientific evidence, nor an endorsement of a specific study, and is not meant as official medical opinion.]
Like many types of cancer, colorectal cancer (CRC) can often be successfully treated if it’s caught early. But, how early should you start looking for it?
Until now, the recommended age for beginning screening for CRC was 50. But, cancer researchers have been concerned about a significantly growing rate of CRC in people younger than 50. Now, new guidelines from the American Cancer Society covered in the Washington Post suggest beginning screening five years earlier – at 45.
(It’s important to note that anyone with a family history of CRC had already been advised to start screening before 50. If you have a family history of this disease, regardless of your age, talk to your doctor about when you should start screening.)
New guidelines for a growing risk
The American Cancer Society changed its guidelines in response to multiple epidemiological studies that showed death rates from CRC have been declining for several decades in people over 50, presumably due to increased screening efforts and identification and removal of colon polyps early in the disease process. At the same time, an alarming increase in CRC rates has been seen in people under 50.
According to a large study published last year in the Journal of the National Cancer Institute, colon cancer rates have doubled annually since the mid-1980s in adults between 20 and 39 years old and have nearly tripled since the mid-1990s in adults between 40 and 54. Rates of rectal cancer have been increasing at an even higher rate during the last several decades in younger adults.
The study concluded that adults born around 1990 have twice the risk of colon cancer and four times the risk of rectal cancer as adults born around 1950. As they age, Gen Xers and millennials will continue to have an elevated risk compared with previous generations, making screening even more imperative.
Although the reasons for the rise in CRC rates in younger adults are not fully known, factors such as obesity, low-fiber diets, physical inactivity, high-fat diets, and lack of fruits and vegetables have all been shown to be associated with increased risk for CRC. So, unfortunately, the modern American lifestyle may be a major contributor to risk for CRC, as well as other cancers.
There are multiple ways to get screened for CRC – it’s not only about having a colonoscopy. Other options include fecal occult blood tests (or high-sensitivity stool tests), which need to be administered every year, or a DNA stool test – sold under the brand name Cologuard – every three years.
For many people, these simple, at-home stool tests can be an easy and lower-cost option to CRC testing. Of course, colonoscopy is considered the gold-standard screening as it provides direct visualization of the colon and can remove any polyps found during the procedure and test them for cancerous cells. Your doctor can help you understand the different options and determine which is best for you.
While the best way to prevent CRC is screening, the American Cancer Society identifies the most important cancer risk factors that person can change and improve – outside of tobacco use – as body weight, diet, and physical activity.
Maintaining a healthy weight – or losing 5 to 10 percent of your weight if you are currently overweight – may lower your risk for CRC. In addition, daily consumption of brightly colored vegetables and fruits, increasing fiber (think whole grains and legumes), and reducing dietary fat and alcohol intake may help lower your risk.