HEALTHY LIVING
New Guidelines Target Colon Cancer
Screening urged for under-50s amid alarming increase in cases. :: BY CHRIS ILIADES, M.D.
W
hile colon cancer rates have been declining for decades in seniors, they have
been rising steadily among those under 50. And colon and rectal cancer,
called colorectal cancer (CRC), is deadly. It is the third-leading cause of cancer deaths in the U.S. for men, and the fourth for women. “Part of the reason cancer rates
have decreased in older patients is because screening works,” says Sean Langenfeld, M.D., a colorectal surgeon at Nebraska Medicine in Omaha. “A properly timed screening colonoscopy can not only diagnose cancers before they become symptomatic (which often occurs at later stages), but it can also identify and remove precancerous polyps before they have a chance to become invasive.” Recently, the CRC screening guidelines were changed, dropping the starting age from 50 to 45. This is because while the rate of new cases of CRC fell by about 1% each year in the last decade among people older than 50, they increased 2.4% each year in those younger than 50. “While most patients develop
colorectal at 65 or older, around 10% of cancers are diagnosed in patients less than 50 years old,” explains Langenfeld. “On a population level, all major
cancer organizations and task forces have concluded that the
80 NEWSMAX MAXLIFE | JUNE 2025
benefits of screening this younger population far exceeds the risk and the cost.”
WHY CRC IS INCREASING While researchers don’t know why CRC is rising in younger adults, it may be lifestyle-related, such as less exercise, more obesity, and diets high in fat and red meat and low in produce and fiber. Another reason is that
doctors may be finding these cancers earlier. Even before the new guidelines, they were seeing younger cases of CRC, so their antennas have been up. “Primary care providers’
threshold for recommending colonoscopy for symptoms such as bleeding and pain has lowered. If a 40-year-old patient had rectal bleeding 15 years ago, it may have been dismissed as hemorrhoids, whereas the same complaint now is more likely to result in a colonoscopy, so some slow-growing cancers that we would have found later are being identified at an earlier age,” Langenfeld said.
Sigmoidoscopy every five years
( examining only the lower colon and rectum with a similar scope)
DNA stool sample test to look for cancer DNA every three years
NEW GUIDELINES For men and women at average risk for CRC, screening should start at age 45 and continue through 75. From age 76 to 85, screening
is optional, should be discussed with your healthcare provider, and depends on your overall health and CRC risk. After age 85, screening is no longer recommended. How often to get screened
depends on the type of screening exam selected. As long as the results remain normal, the options are:
Colonoscopy (examining
the entire colon with a flexible telescope) every 10 years
Sigmoidoscopy (examining only
the lower colon and rectum with a similar scope) every five years A CT scan imaging study of the
colon (virtual colonoscopy) every five years DNA stool sample test to look for cancer DNA every three years Stool sample tests that look for
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