New guidelines move back age to start colon cancer screening

DES MOINES — The guidelines are changing for the age at which people should begin getting screened for colon cancer, which is the third most common cancer in Iowa and the state’s second leading cause of cancer death.

March is Colon Cancer Awareness Month, and Dr. Samir  Shah, president of the American College of Gastroenterology, says screenings should now start at age 45, not 50. “Colon cancer remains the second-leading cause of cancer death in both men and women and the third-most common cancer in both groups,” Shah says. “It’s so important to screen for it because, of all the major cancers, it’s the most preventable. It can be prevented in 90% of patients with proper screening.”

Beginning the screenings five years earlier raises the chances of survival if cancer is found. He says studies are finding that late-stage colon and rectal cancers are increasing dangerously among younger people. “If you’re 45 and older, call your primary care provider and say ‘It’s time for my colonoscopy,’ and they’ll say, ‘Yep, we’ve been meaning to call you, the guidelines just changed,’ and then they’ll give you a menu of options,” Shah says. “The option that’s the best is the colonoscopy because it’s a one-stop shop. If they find polyps, they will remove them and you’re all set.”

For Iowans who would prefer not to start with the colonoscopy, there are other options to screen for the disease. “You can get a stool-based test to look for either blood in the stool or DNA in the stool that would predict the presence of a polyp or cancer,” he says, “and if that test is positive, then you go for the colonoscopy.”

Research shows people younger than 40 experienced the steepest rise in advanced cases of late-stage colon and rectal cancers between 2000 and 2016. Shah says starting screening at age 45 improves the chances of finding polyps and cancers sooner and hopefully preventing late-stage disease and death.