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Colorectal screening before 50 can reduce risk of colon cancer: Study

Rajeev Choudhury

Women, who undergo colorectal endoscopy screening before the age of 50, remain at a lesser risk of developing colorectal cancer, researchers from a recent study said.

The study, led by Andrew Chan of Massachusetts General Hospital, was published in the journal JAMA Oncology recently and supports the recommendations from the American Cancer Society and the US Preventive Services Task Force over the past four years to commence screening at age 45 to address the steady increase in cases of younger-onset CRC.

Women who started endoscopy screening at the age of 45 to 50 showed a significant reduction in the total diagnosis of colorectal cancers, the researchers of the study reported.

Those who started screening at age 45 were 50-60% lower at risk of developing colorectal cancer (CRC), they further reported.

“While there’s been an alarming increase in the incidence of colorectal cancer in recent decades in younger individuals, screening has largely been focused on people over 50,” says Dr Andrew Chan, a gastroenterologist and epidemiologist at MGH, and senior author of the study.

“Our work provides first-of-its-kind data to show that initiating screening at a younger age can reduce an individual’s risk of colorectal cancer and the population’s overall incidence of cancer, thus demonstrating the substantial impact of earlier screening on both individual and population-wide scales,” he added in a statement.

According to the estimates by the American Society of Clinical Oncology, colorectal cancer is the third most common cause of cancer and cancer-related death each year across the globe.  

Various epidemiological data suggest that even though the incidences of colorectal cancer have been decreasing across the United States since the mid-1980s, the incidence among the younger populations under the age of 50 has been steadily increasing and increased by 51% from 1974 to 2013.

Researchers found a 50-60% lower risk of CRC among women who started endoscopy screening at age 45 compared to those who had not undergone screening at all.

Additionally, they found that those who started screening at ages 45 to 49 resulted in a significant reduction in the population’s actual cases of CRC diagnosed through age 60, compared to a strategy in which women began screening at ages 50 to 54.

Though the study has focussed on women, the researchers suggest that men could also benefit from such a screening programme.

However, more studies are needed to confirm this, Chan says.

Colonoscopy is an invasive screening tool for CRC, where the doctors insert a flexible tube fitted with a camera to examine the colon and rectum.

This invasive technique allows for the removal of polyps that could over time become malignant, and for the detection of early-stage cancers that can be treated more effectively.

Pointing out the public health implications of his team’s research, Chan said, “Any trepidation that clinicians might have had about the effectiveness of CRC screening at a younger age will hopefully be allayed by these results.”

“Our data show that we have an effective tool to address the epidemic of colorectal cancer among younger adults, and hopefully this will encourage physicians to have a conversation about screening with their younger patients which, in turn, will motivate them to follow through and get screened, ” he adds.

 


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