Colorectal Cancer Screening

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A recent proposal by the U.S. Preventative Services Task Force recommends that adults should start screening for colorectal cancer routinely at age 45, instead of waiting until age 50.  The task force is an independent group of experts appointed by the Department of Health and Human Services. While it still must be finalized, its guidance on screening and preventative care services reflects a rise in higher rates of colon and rectal cancer in generations born since 1950, The New York Times states. According to a study by the American Cancer Society, 12% of the 147,950 colorectal cancers that will be diagnosed this year will be found in adults under the age of 50; that is over 18,000 cases.

A group disproportionately affected is African Americans, who are 20% more likely to get colorectal cancer, and 40% more likely to die from it that most other groups. This is due to a combination of complex reasons, including risk factors, health care access, and socioeconomic status.

An article published in JAMA Network examined the incidence rates of colorectal cancer in 1 year increments, focusing on the transition between ages 49 and 50 years of age. Researchers studied 165,160 patients from a variety of demographic backgrounds and geographical regions from 2000-2005. They observed the colorectal cancer incidence rates in 1-year age increments (30-60 years) in the Surveillance, Epidemiology, and End Results 18 registries (STEER 18). They found an incidence rate increase of 46.1% from 49 to 50 years of age. A total of 92.9% of the cases of colorectal cancer diagnosed at 50 years of age were invasive (beyond situ stage).

The steep incidence increases from 49 to 50 years of age are consistent with preexisting colorectal cancers diagnosed via screening uptake. These findings suggest the presence of a large undetected preclinical case burden in patients younger than 50 years old that is not observed in the STEER 18.

These results support the recommendation to begin screenings earlier. The panel also emphasized that health care providers should especially encourage black men and women to be screened at 45 due to high rates of disease and higher death rates in the African American community.  Dr. Kimmi Ng, director of the Young-Onset Colorectal Cancer Center at the Dana-Farber Institute in Boston comments “Lives will be saved. We will be preventing cancers in young people, catching them at an earlier stage when they are more likely to be curable, and hopefully improving survival rates.”

While some physicians are vigilant, some younger patients feel their complaints are dismissed by doctors. The Colorectal Cancer Alliance states 81% of young adults with colorectal cancer said they experienced at least three symptoms of cancer before getting diagnosed. Additionally, more than half were misdiagnosed with hemorrhoids, anemia, IBS, or mental health problems. Abramson, Brown & Dugan is committed to advocating on behalf of people who have not received adequate preventative care, diagnosis, or treatment by health care professionals. If you or someone you know has been affected by medical malpractice, contact us today.

Jared Green
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