Should the Screening Age for Colorectal Cancer Be Lowered?

Albert B. Lowenfels, MD Posted: 10/21/2011 Is It Time to Lower the Recommended Screening Age for Colorectal Cancer? Davis DM, Marcet JE, Frattini JC, Prather AD, Mateka JJ, Nfonsam VN J Am Coll Surg. 2011;213:352-361 Summary The authors used cancer incidence data from the SEER database to analyze age-specific changes in the incidence of colorectal cancer in the United States. A marked increase in the incidence of colorectal cancer was found in the 40- to 44-year age group. In 1987, the incidence was 10.7 per 100,000; in 2006, the incidence had climbed to 17.9 per 100,000, an increase of 67%. The increase was even more pronounced for rectal cancer, amounting to over 3% per year. However, incidence rates for colorectal cancer in the > 50 age group decreased. Viewpoint The currently accepted screening age for colorectal cancer is 50 years. The authors of this report suggested that lowering the screening age may be appropriate on the basis of data that showed a significant increase in the incidence of colorectal cancer in younger individuals, especially in the rectum. Although sigmoidoscopy would be adequate for detecting rectal tumors, many tumors in the colon would escape detection. The authors pointed out that the incidence of colorectal cancer in younger individuals resembles the incidence rate of similarly aged patients with cervical cancer -- a group that is routinely screened. Estimates of the cost of lowering the screening age were not included and still need to be obtained.