Proposed lowering of colorectal cancer screening to age 45 may drive increase in cases

GlobalData Healthcare 24 November 2020 (Last Updated November 24th, 2020 16:33)

Colorectal cancer (CRC) is responsible for more than 50,000 deaths per year and is the third most fatal type of cancer in the US. On October 27, the US Preventive Services Task Force (USPSTF) proposed new guidelines for CRC screening. If the proposed guidelines are accepted, the new eligibility criteria will likely drive an increase in new CRC cases.

Proposed lowering of colorectal cancer screening to age 45 may drive increase in cases
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Colorectal cancer (CRC) is responsible for more than 50,000 deaths per year and is the third most fatal type of cancer in the US. On October 27, the US Preventive Services Task Force (USPSTF) proposed new guidelines for CRC screening. If the proposed guidelines are accepted, the new eligibility criteria will likely drive an increase in new CRC cases.

The guidelines, which were last updated in 2016, would now lower the screening age of adults from 50 years to 45 years, up until age 75 years. The draft proposal follows an increasing body of evidence that suggests a rising risk for adults ages 45–49 years in developing CRC. A 2017 study published by the Journal of the National Cancer Institute found that between the mid-90s to 2016, the rates of colon cancer increased by 1.3% each year, while the rates of rectal cancer increased by 2.3% each year among adults under age 50.

In the US, GlobalData epidemiologists forecast the number of diagnosed incident cases of CRC to be approximately 140,000 cases in 2020, and expect this to grow to about 162,000 cases in 2028 (as shown in Figure 1). However, if these new guidelines take effect, the number of diagnosed incident cases will likely surpass the current forecast estimates through 2028 as a result of increased case identification. The expanded screening criteria will help capture more of the potentially at-risk population and initiate screening in individuals without symptoms. Moreover, while the benefits of CRC screening are still greatest for people ages 50–75 years, additional deaths due to CRC can be prevented by starting screening at age 45. Ultimately, the new recommendations will result in earlier disease detection and improved patient outcomes.

The public comment period on the draft recommendation will be open until November 23, with final recommendations expected to be released in the next few months. GlobalData epidemiologists suggest that a further analysis of the surveillance data should occur over the next five years to more clearly assess, characterize, and quantify the impact these new guidelines will have.