The recent guidelines for cancer screening have seemingly led to an uptick in diagnoses among younger Americans. Two studies from the American Cancer Society (ACS) indicate a noticeable rise in colorectal cancer among individuals aged 45 to 49.
According to ACS research, after a 15-year period where colorectal cancer rates were relatively stable, there has been a significant jump in local stage disease diagnoses between 2019 and 2022. Specifically, there was a 50% relative increase in diagnoses from 2021 to 2022.
“This is promising news,” commented Elizabeth Schafer, a lead author and ACS scientist, in a press release.
Back in 2018, the ACS lowered its recommended age for colorectal cancer screenings from 50 to 45, a change that the US Preventive Services Task Force (USPSTF) adopted in 2021.
The first study published in the Journal of the American Medical Association (JAMA) examined CRC diagnoses from 2004 to 2022 among adults aged 20 to 54. For those aged 20-39, the annual increase has been about 1.6% since 2004, and this trend has risen to over 2% per year for the older age brackets of 40-44 and 50-54. Notably, the 45-49 age group experienced an annual jump from 1.1% to 12% between 2019 and 2022.
ACS confirmed that the rise in localized tumors contributed significantly to these findings, with colon cancer detections increasing nearly 19% yearly and rectal cancer by over 25% during the same timeframe. Prior to this surge, the rates for colon cancer were quite stable, while those for rectal cancer were declining.
Moreover, cases of advanced stage disease have also escalated sharply. Since 2004, rates among adults under 45 have climbed from 1.7% to 2.9% yearly, with an even quicker rise for those aged 45 to 54 in the last decade. This led to another ACS study published in JAMA, which reported that CRC screenings for adults between 45 and 49 surged by 62% from 2019 to 2023.
The data analyzed included over 50,000 individuals, and it revealed that CRC screening rates climbed from 20% in 2021 to 37% in 2023. For the 45-49 cohort, colonoscopy screening rose by 43%, while stool-based testing saw a five-fold increase from 2019 to 2023.
Jessica Starr, an ACS scientist based in Atlanta, sees this surge in screening for younger individuals as “thrilling,” linking it to earlier stage diagnoses. “But we still have a long way to go,” she added, pointing out that screenings for those aged 45 to 49 aren’t reaching optimal levels and are not distributed evenly across different educational and insurance backgrounds.
Dr. Paul E. Oberstein, a medical oncologist at NYU Langone Perlmutter Cancer Center, emphasized that the increase in screenings could lead to earlier detection of cancers, which are much easier to treat. “This means fewer late-stage diagnoses and potentially fewer severe cases of colon cancer,” he explained.
He also highlighted the need for more research into the causes of colon cancer and approaches to mitigate its rise. Although cancers in patients under 45 are still relatively uncommon, it remains uncertain if universal screening at younger ages would be beneficial. Some individuals, particularly those with a family history or specific risk factors, might benefit from earlier screenings.
Dr. Craig Eagle, chief medical officer at Guardant Health, stressed the importance of early detection, noting that the five-year survival rate for colorectal cancer surpasses 90% when caught early. “The rise in diagnoses among people in their 40s serves as a crucial reminder that we need to make screenings easier and more accessible to the approximately 50 million Americans who remain unscreened,” he urged.
