Lowering the CRC screening age to 45: Pros and cons

Two leading gastroenterologists debated colorectal cancer screening at the 2020 Gastrointestinal Cancers Symposium, Jan. 23-25 in San Francisco, as reported by Targeted Oncology.

What you should know:

Pro: Uri Ladabaum, MD, of Stanford (Calif.) University, supported lowering the CRC screening age to 45. He cited disease burden, the role of modeling and the effectiveness of screening as reasons why.

The American Cancer Society released a guideline in May 2018 that recommended lowering the initial screening age from 50 to 45 to combat the growing incidence rate of early-onset CRC cases. Worldwide, CRC incidence rates are increasing in adults under 50 while incidence rates in adults over 50 are decreasing.

Dr. Ladabaum admitted that challenges remain around determining individuals who are most at risk for developing CRC, and that a lower screening age recommendation alone would not solve the growing problem of early-onset CRC.

Con: David Weinberg, MD, from Philadelphia-based Fox Chase Cancer Center, was against lowering the initial screening age to 45 and argued to keep it at 50.

Dr. Weinberg agreed that while the early-onset CRC rate is increasing, the risk associated with the increase is relative, with the absolute risk affecting only 1.3 percent of people 40 or younger. He also noted while incidence rates are increasing, mortality rates have stayed the same and would continue to stay the same despite increases in screening.

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