New federal colorectal cancer guidelines encourage earlier attention

Published on Thursday, July 1, 2021

By: Ruth Cummins

It’s official: Screening for colorectal cancer should now begin at age 45, not 50, for average-risk Americans, the U.S. Preventive Services Task Force says.

The federal body’s recommendation finalizes draft guidelines issued in October 2020 and aligns with the recommendation age for a first screening advocated by the American Cancer Society.

That’s good news for Mississippians, said Dr. Roy Duhe, professor of pharmacology and toxicology at the University of Mississippi Medical Center and a longtime advocate of life-saving colorectal cancer screening. Duhe also is a professor of radiation oncology and associate director for cancer education.

“Over the past two decades, the occurrence of colorectal cancer has increased by nearly 15 percent in Americans who are between the ages of 40 and 49,” Duhe said. “This means our nation has reached a point where approximately 10 percent of all colorectal cancers occur in Americans before they reach the age of 50.”

"New statistics project an alarming rise in the incidence of young-onset colorectal cancer, projected to be the leading cause of cancer death in patients aged 20 to 49 by 2040," Dr. Kimmie Ng, director of the  Young-Onset Colorectal Cancer Center at the Dana-Farber Cancer Institute in Boston, said in a news release. Ng is lead author of a Journal of the American Medical Association editorial about the new guideline.

Duhe was a founder of the 70x2020 Colorectal Cancer Screening Initiative that had a goal of at least 70 percent of eligible Mississippians being screened by 2020. Latest data from the Mississippi Cancer Registry shows that in 2018, 1,817 Mississippi residents were diagnosed with colorectal cancer.

“When you compare the colorectal cancer screening rates in Mississippi to those in other states, we rank pretty low on the list, although there are a couple of states that are between us and rock bottom,” Duhe said. “But if you consider the actual colorectal cancer screening, incidence and mortality rates in Mississippi, you will notice that we have made steady, but painfully slow, improvements over the past seven years.”

Plenty of people avoid getting a colonoscopy because of the inconvenience, or because preparations for it several days before the outpatient procedure can be unpleasant. However, their lives might depend on it, Duhe said.

“I’ve had a screening colonoscopy myself and found that it wasn’t a bad experience,” he said. “The minor inconvenience was well worth the peace of mind I had knowing there were neither any pre-cancerous polyps nor any cancers in my colorectal tract.

“The most common complaint I hear about colonoscopies is that people don’t like drinking ‘the prep’ solution and spending a lot of time in the bathroom as a result,” he said. “I would remind them that it’s essential to clean all that stuff from their intestines. A colonoscopy involves moving a tiny camera through a part of the human body, and if the colon is full, then your gastroenterologist won’t be able to see” the necessary areas.

If someone doesn’t want to get a colonoscopy despite the health benefits, Duhe said, they can discuss options with their physician that may be less effective, but that can be done at home.

“As the saying goes, ‘the best screening option is the one that gets done,’” Duhe said. 

“We need to continue to remind people of the importance of getting screened, because colorectal cancer screening literally saves lives,” Duhe said. “That might be your life, or it might be the life of someone you love, so get screened.”

To make an appointment for a colonoscopy at UMMC Gastroenterology, call (601) 984-4540.

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