Colorectal Cancer Develops Earlier Than Presumed

A new study suggests colorectal cancer (CRC) screening should begin at 45 years of age, so as to match rising mortality rates in young adults.

Researchers at Clinique de Bercy (Charenton-le-Pont, France) analyzed 6,027 colonoscopies in order to identify neoplasia, adenoma, and polyp detection rates and rank them according to age. The results revealed a 400% increase in neoplasia detection in patients aged 45 to 49, when compared to patients in the 40 to 44 age group. The researchers also found that the neoplasia detection rate was 8% higher in the 45 to 49 age group than in the 50 to 54 range.

The mean number of polyps detected in the inner lining of the colon and adenoma detection rates also increased by 95.8% and 95.4% (respectively) between the 40 to 44 and 45 to 49 age groups. This was far more substantial than the increase between the 45 to 49 and the 50 to 54 age groups, which was 19.1% and 11.5%, respectively. The researchers therefore suggest that CRC screening begin at age 45. The study was presented at the 25th United European Gastroenterology (UEG) Week, held during October 2017 in Barcelona (Spain).

“Even when patients with a familial and personal history of polyps or cancer are excluded from the findings, there is still a noticeable increase in detection rates in patients from the age of 45,” said lead author and study presenter David Karsenti, MD, of the digestive endoscopy unit. “The results of our research strongly indicate that screening for colorectal cancer should begin at the age of 45; this will help us to increase the early detection of colorectal cancer in young adults, and also enable the identification and safe removal of polyps that may become cancerous at a later date.”

CRC is the second most common cause of cancer-related death in Europe, killing 215,000 Europeans every year, with research showing that three in ten CRC diagnoses are now among those younger than 55. Despite strong evidence that screening for CRC reduces incidence and mortality rates, there are vast inequalities in CRC screening across Europe, with the vast majority of screening programs commencing between the ages of 50 and 55, with some not beginning until the age of 60.

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