Doctors say colon cancer screening should begin before 50

A survey of 1,419 of those doctors found that:

• 56 percent think that increased incidences of obesity and diabetes are to blame for colon cancer becoming more widespread among young adults
• 42 percent feel regular screening for colon cancer should begin at age 40; 25 percent feel it should begin at 45; 25 percent said it should begin at age 50

The poll was conducted in honor of Colorectal Cancer Awareness Month and in response to a recent study in the journal Cancer Medicine that found that nearly 15 percent of colorectal cancer patients are diagnosed before age 50. A separate analysis published in Cancer found that younger patients were more likely to have advanced stage cancer.

“Colon cancer is prevented by screening colonoscopy,” said oncologist Dr. Laura Allen. “Regardless of family history, every person should have a screening colonoscopy at age 50. If there are any symptoms or a family history, patients should discuss this with their personal physician for consideration of colonoscopy at a younger age.”

Many of those 50 and over, for whom regular colorectal screening if recommended by the United States Preventive Services Task Force, are still not getting the screening, which can prevent colon cancer. Data from the Centers for Disease Control and Prevention from 2013 shows that 60 percent of whites, 58 percent of African Americans, 51 percent of Asians and 42 percent of Hispanics ages 50 – 75 were up to date on the screening.

The majority of the doctors polled by Sermo feel that non-invasive colonoscopy alternatives can increase colon cancer screening rates. However, there was more confidence in computer tomography colonography, often called virtual colonoscopy, than Cologuard, the DNA screening for colon cancer that was approved by the FDA last year.

• 68 percent said computer tomography colonography (CTC), often called virtual colonoscopy, should be covered by Medicare and 76 percent thought that Medicare coverage would increase screening rates
• 53 percent said that they would not recommend Cologuard as a primary colorectal cancer screening test

Sermo is the virtual doctors’ lounge so it’s only natural that doctors decided to provide comments in the network about the prospect of lowering the recommended age for regular colon cancer screening.

A pathologist said, “I think we should use fecal blood and possible genetic testing in younger patients with strong family history and fecal blood stool testing for younger patients starting at age 40 without a significant history. This test is a lot less invasive.”

A pain medicine specialist recounted his own experience as a colon cancer patient under 50, “I was diagnosed with colorectal cancer at age 46. No risk factors (anal sex, diet, family history, obesity…). I was living on salad, never eating processed meat, pork and minimal red meat. While I was waiting in the CT waiting area I noticed a lot of people in their early 40s without any family history talking about their unexpected diagnosis. My wife said that there were many women in their late 30’s and early 40’s talking about the unexpected diagnoses of their young husbands…Current guidelines do not seem to be sufficient as all these people slipped through the cracks. Maybe we should start routine FOBT [fecal occult blood test] and fecal DNA screening at age 40 and the first colonoscopy at age 45?”

An emergency medicine doctor argued, “While colon cancer MAY occur in a younger population, if you had to consider both sensitivity and specificity (false positives and negatives), you would be best advised to choose a somewhat older population.”

A physical medicine doctor said, “We need to stratify screening guidelines based on genetic and any other risk factors we can find…It would not make sense to screen the whole population for colon cancer at age 30, but it would make sense to screen identified people with family history of genetic predisposition even earlier.”

An anesthesiologist added, “Cancer screening seems more cost-effective than the last 3 weeks end-of-life care.”

This Sermo poll was administered via email to a random selection of members of the Sermo community in the United States. Participation was voluntary and results were kept anonymous. The margin of error is ±3 percent. The question about lowering the age for regular screening for colon cancer was also posted within the Sermo social network, accounting for the larger sample size (only one vote was counted per participant). The margin of error for that question is ±2 percent.

For more information on the methodology of Sermo polls, please go to https://www.sermo.com/polls.

For an infographic with the full poll results, please click here.

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About Sermo

Sermo is the leading social network for physicians – the world’s largest virtual doctors’ lounge where doctors talk real world medicine. Sermo’s mission is to revolutionize real world medicine by providing physicians a safe, private and trusted platform for free and open dialogue on an unprecedented global scale. Sermo has more than 550,000 fully verified and licensed members and is now available for doctors in 24 countries: Argentina, Australia, Canada, Chile, Colombia, Denmark, Ecuador, Finland, France, Guatemala, Ireland, Israel, Italy, Mexico, the Netherlands, New Zealand, Norway, Peru, South Africa, Spain, Sweden, the UK, the US and Venezuela. Sermo is also the world’s largest health care professional polling company with 1.8 million HCPs in both the social network and a digital research network, spanning 80 countries. Sermo conducts 700,000 surveys a year.

Learn more at www.Sermo.com

Media Contacts:
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Cassidy Lawson, Racepoint Global
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Osnat Benshoshan, Chief Marketing Officer, Sermo
osnat.benshoshan@sermo.com