The US Food and Drug Administration (FDA) has expanded its approval of the at-home non-invasive colorectal cancer screening test Cologuard, to include use among average-risk individuals aged 45 and older.
This approval from the FDA provides another opportunity for us to have a conversation around screening and another conversation around the screening age.
Since 1994, America has seen a 51% increase in bowel cancer cases among Americans under the age of 50.
To address this worrying trend, the American Cancer Society (ACS) changed its screening guidelines in May 2018, to recommend lowering the starting age from 50 to 45 years.
The drop in the screening age by the ACS was a significant moment for the bowel cancer community and marked an important first step in acknowledging that bowel cancer does not discriminate, affecting men and women, young and old.
Bowel cancer is also on the rise in people under age 50 in Australia, New Zealand, Denmark, and the UK according to a global study published in The Lancet Gastroenterology & Hepatology.
Never assume you’re too young for bowel cancer. While bowel cancer is more common in people over 50, almost 1 in 10 new cases now occur in Australians under 50.
Given these increasing rates among younger Australians, we need to review screening guidelines and consider lowering the starting age from 50 to 45, in line with the American Cancer Society recommendation.
“The age at which bowel cancer screening starts should clearly be reviewed,” said colorectal surgeon, A/Prof Graham Newstead AM.
Currently, a consensus-based recommendation contained within Australian medical guidelines states GPs can offer an at-home screening test every two years to people aged 45-49 who request it, after being fully informed of the benefits (and any possible harms) of testing.