At what age should you really (!) start a screening colonoscopy? 45 or 50?

At what age should you really (!) start a screening colonoscopy? 45 or 50?  The American Cancer Society (ACS) recently released an updated guideline that colorectal cancer (CRC) screening begin at age 45 for patients at average risk.

Researchers have demonstrated a favorable benefit-to-burden balance of screening beginning at age 45.  The new guideline differs from the latest recommendation by the U.S. Preventive Services Task Force released June 2016.

ACS has acknowledged that this recommendation is considered a “qualified recommendation” in that this conclusion relies on the use of modeling without evidence from clinical trials.  Most published studies clinical studies regarding screening for colorectal cancer are in those 50 and older.

Did you know that there has been a steady decline of colorectal cancer during the past twenty years in patients 55 and older due to screening that results in removal of polyps.  Conversely, there has been a 51% INCREASE in colorectal cancer in those younger than 50.  It is thought that this increase in colorectal cancer is that screening begins at 50.

What is the harm of starting screening at age 45?  It may be that the number of lifetime colonoscopies will increase and with every procedure there are potential harms.

When the screening age for colonoscopies was first decided to be at age 50, the rate of colorectal cancer was the same as it is now for 45 year olds.  It is suggested that recommendations are constantly revisited.

If you are considering your first colonoscopy before age 50, confirm with your individual insurer that this will be a covered benefit.

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About drlesliegreenberg

I have been practicing as a family physician for over 20 years--as both an educator of physicians and clinician. From infancy to the elderly, I perform obstetrics and general medicine. I love my career and am passionate about my field of knowledge and my patients. Follow me on Facebook at Leslie Md Greenberg Medical Disclaimer The content of this website is provided for general informational purposes only and is not intended as, nor should it be considered a substitute for, professional medical advice. Do not use the information on this website for diagnosing or treating any medical or health condition. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider.
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