From Dr. Bhandari – Colorectal Cancer Rates Are Increasing In Younger People
From Dr. Bhandari – Colorectal Cancer Rates Are Increasing In Younger People
Colorectal cancer (CRC) is the second most common cause of cancer death when numbers for men and women are combined in
the US and worldwide. CRC is now the leading cause of cancer death in men under the age of 50, and the second in women in
this age group. This represents an alarming trend of CRC deaths in younger Americans as early as the third and fourth decade
of life. The cause of this trend is currently unknown, but most researchers believe a variety of factors (genetic and
environmental) affecting the internal microbiome (genetic material of all microorganisms that reside in the intestinal tract)
which alter our immune system leading to CRC in younger people.
CRC is mostly preventable with CRC screening and now starts at age 45 (previously 50), in average risk people. The method of
screening is largely dependent on your risk if developing CRC.
1. Average risk (age 45 or older)
• Without polyps
• Without high risk factors listed below
Fecal Immunochemistry Test FIT – Test every year
Cologuard – Every 3 years
Colonoscopy – Every 10 years
If FIT or Cologuard is positive, a colonoscopy will be required.
2. Do you have symptoms?
• Rectal bleeding
• Change in Bowel Habits
• Persistent abdominal pain
• Unintentional weight loss
• Chronic diarrhea
If yes, colonoscopy is recommended.
3. Do you have a personal history?
• Previous history of colon polyps or colorectal cancer, colonoscopy is recommended.
4. High Risk factors
• Family history of colorectal cancer or precancerous polyps in a first degree relative before age 60
• Multiple first degree relatives with colorectal cancer or precancerous polyps
• History of Ulcerative Colitis/Crohn’s disease
• Family history of an inherited CRC syndrome
If any, colonoscopy before the age of 45 is recommended. Age varies on family history.
Now available are computer aided polyp detection systems powered by AI. Studies show that endoscopies with high
adenoma (precancerous polyp) detection rate (ADR) during screening colonoscopies more effectively protect their patients
from Colorectal cancer. With AI, studies have shown an increase of ADR to 14.4% and for each 1% in increase in ADR, there is
a corresponding decrease in the rate of interval colorectal cancer (CRC between 2 successive colonoscopies) by 3%.
Unfortunately, 1/3 of US adults are not getting CRC screenings, but there is good news:
*CRC screenings are often covered by your health insurance.
*90% Survival rate when detected early.
Talk to your primary doctor and get your screening scheduled.
Bal Raj Bhandari, M.D.
