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By Scot Ackerman

M.D. on 03/14/2017

Colon Cancer Trends May be Tied to Screening Effectiveness

A recent analysis published by the American Cancer Society revealed colorectal cancer diagnoses and death rates have decreased for those 50 and older in recent years, while colon cancer rates are on the rise in younger adults.

The retrospective study found that colon cancer diagnosis in adults over 50 fell 32 percent since 2000, and death rates dropped 34 percent during the same period. I believe the reduction in colorectal cancer rates can be credited to a vigorous screening protocol. 

Unfortunately, the falling number of colon cancer cases in older adults is in sharp contrast to those of younger Americans who have seen a 1 to 3 percent annual rise in the incidence of colorectal cancer over the past several decades.

Although a cause for the increasing colon cancer rates in young adults has not been identified, lifestyle could play a role. Since colorectal cancer risk is linked to being overweight, smoking, insufficient exercise, and high fat low fiber diets, lifestyle habits of millennials are suspected to be a contributing factor. 
A lack of colon cancer screening protocols for younger adults also means colon cancer diagnosis is often delayed. Most colon cancer arises from benign adenomatous polyps that develop in the colon. There are typically no symptoms until the cancer reaches an advanced stage.

Routine colon cancer screening is the best way to detect colorectal cancer in the earliest stages, when it is the most treatable. And while rates are climbing among younger Americans, those over 50 remain the most at risk group for the disease.

Current screening recommendations call for adults at average risk to begin colon cancer screening at age 50 using one of the following screening tests to detect polyps and/or cancer:
• Colonoscopy – every 10 years
• Flexible Sigmoidoscopy – every 5 years
• Double Contrast Barium Enema – every 5 years
• Virtual Colonoscopy (CT Colonography) – every 5 years

Screening tests used to detect colon cancer only – not polyps – include:
• Guiac-Based Fecal Occult Blood Test – yearly 
• Fecal Immunochemical Test – yearly
• DNA Test of Stool – every 3 years

All abnormal tests should be followed up with colonoscopy and individuals considered high risk due to personal history of polyps, colon cancer, and inflammatory bowel disease, or those with strong family history of the same conditions or of familial adenomatous polyposis or Lynch Syndrome, should begin testing at an earlier age. African Americans are also advised to begin colon cancer screenings at age 45.

In 2010, only about 59 percent of adults over 50 were up-to-date on colon cancer screening, even though current statistics prove the value of screening. I urge all adults to follow the recommended colorectal cancer screening guidelines and encourage younger adults to seek prompt medical care for symptoms of bloating, abdominal pain, rectal bleeding and persistent diarrhea.

For questions about colorectal cancer or colon cancer screening, please contact me at ackermanmd@ackermancancer.com

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