Posted on 05/20/2021 8:28:54 AM PDT by Red Badger
Screening for colorectal cancer—the second most common cause of cancer-related death in the United States—can save lives by detecting both pre-cancerous lesions that can be removed during the screening procedure, and colorectal cancer in its early stages, when it is highly curable.
Cancer — Histopathologic image of colonic carcinoid. Credit: Wikipedia/CC BY-SA 3.0
_________________________________________________________________________________________
Screening is most commonly performed with endoscopy: visualization of the entire colon and rectum using a long flexible optical tube (colonoscopy), or of the lower part of the colon and rectum with a shorter flexible tube (sigmoidoscopy).
This week, the United States Preventive Services Task Force (USPSTF) lowered the recommended beginning age for screening from 50 to 45 for persons without a family history of colorectal cancer. However, its recommendation to continue periodically until age 75, after which the decision to undergo screening can be based on an individual's health and risk factors, remains unchanged.
Yet there has been very little hard evidence to support or contradict the recommendation to stop routine screening at age 75—until now. As researchers from Massachusetts General Hospital (MGH) report in JAMA Oncology, screening endoscopy for persons older than 75 in otherwise good health can reduce the risk of colorectal cancer incidence and cancer-related death by approximately 40%.
The researchers also found, however, that screening did not provide a significant survival benefit for individuals older than 75 with cardiovascular disease, diabetes or three or more other health conditions.
"Until now, there really weren't clear data to help us decide whether patients should be screened after age 75," says co-investigator Andrew T. Chan. MD, MPH, a gastroenterologist and chief of the Clinical and Translational Epidemiology Unit at MGH. "Current guidance was largely based on modeling and extrapolation of studies conducted in other age groups, and not on solid data to show whether screening was actually helpful in an older population."
To answer this important question, Chan and colleagues looked at data on the incidence of colorectal cancer and colorectal cancer-related deaths among participants in two large U.S. health studies: the Nurses' Health Study and the Health Professionals Follow-up Study. In both, participants fill out biannual questionnaires on demographics, lifestyle factors, screening, medical history and disease outcomes.
For the current study, the investigators examined data on participants who were followed from 1988 through 2016, focusing on the history of screening sigmoidoscopy or colonoscopy in 56,374 who reached 75 years of age during study follow-up.
The researchers identified 661 cases of colorectal cancer and 323 colorectal cancer-related deaths after age 75.
They found that screening after age 75 was associated with a 39% decrease in colorectal cancer incidence and a 40% decrease in risk of death related to colorectal cancer, regardless of whether participants had been screened before age 75.
Among participants who had undergone screening before 75 years of age, screening after age 75 was associated with a 33% reduction in colorectal cancer incidence and a 42% decrease in colorectal cancer-related death compared with those who were not screened after reaching 75.
Similarly, for participants who were screened for the first time only after age 75, the respective declines in incidence and death were 49% and 37% compared with those who were never screened.
In contrast, participants with cardiovascular disease or multiple co-morbidities did not benefit from screening after 75.
"These are the first empirical data that really demonstrate that there is value in continuing screening past age 75 for many individuals. But the key take-home message is that screening should be tailored according to individual risk factors," says Chan.
Explore further
Study finds disparities in colorectal cancer screenings
More information: JAMA Oncology (2021). DOI: 10.1001/jamaoncol.2021.1364
Journal information: JAMA Oncology
Provided by Massachusetts General Hospital
My son never had any symptoms until he found blood, then made the appointment to get it checked out.
Yikes!
It’s gotta be the modern diet and all the chemicals in foods........................
More than likely.
That’s a gene test to see if you are vulnerable to cancer. This is a blood test to see if you have cancer right now.
My father was dx’d w/nasopharyngeal cancer and died in 1981 at age 56 after about 4 years of radiation/chemo. I’ve read various theories about why it’s prevalent in parts of China; at the time, the docs had no idea why my father had it. He’d traveled through out Europe in WWII but had never been to the far east.
Thank God I went at age 49, a year early. After locating four large tumors, re-section ( about 10 inches shorter) , no problems 17 years later. Doc said ‘ another year, we’d be rolling the dice on your survival’.
Everybody in my family smoked except me. They were all chimneys. Both my parents and one sister died of lung cancer. My brother quit smoking after he had his first heart attack at the age of 48. Had he lived past 51 when he died of a second heart attack, he would have probably contracted cancer. My oldest sister who was an alcoholic, and was institutionalized most of her adult life, died of a stroke at the age of 74 in 2014. She'd outlived everyone else but me. I'll be 74 in August. Although I never smoked, I know there is still a possibility that I may contract cancer. My parents never had the benefit of chemo or radiation, but lung cancer will eventually kill you, no matter what treatments you take. My second oldest sister stopped smoking five years before being diagnosed with lung cancer. After seeing her go through radiation, chemo, more radiation, etc., I don't know if I'd even want to go through all that, put my kids through all of that, especially if it meant it would give me 6-18 more months. What's the sense?
MCARE pays for it
The prep is a total drag. I get one every 5 years due to bad family history with colon cancer. I’d prefer the prep over the cancer - watching my father die of it wasn’t pleasant.
Stories like yours is important to hear as it motivates people to go thru the process. Thxs for sharing and sorry to hear about your dad!
Let’s just stir up some more fear. I’d rather read the daily garbage from Breitbart, The Hill, and Politico than read about everybody’s colonoscopy. My father died of lung cancer. It was terrible. I’ll spare you.
We are all going to die. Get right with God. Pray often. When it’s time, be ready and full of grace.
I messed that up the way I said it. I meant to say that you/they should start earlier than currently recommended...which I believe is 55.
I 've had three tests and no polyps. I'm 77.
Not that I want to go anytime soon but, I believe I’ll do okay when it’s time. :-}
Butt and or face... I heard it helps psycolonlogically.
Not making light of cancer here, my dad died of it and also my aunt.
Bone cancer and Leukemia.
My nephew died of Leukemia at 17.
Friend had the test from box. Said positive for cancer. Family scared to death. Had to wait 2 months for appt for colonoscopy. He was Cancer free.
Ouch! That really is a bad story.
Yep. That’s why I say careful using those box tests. A lot of false positives. Just like covid.
Not just hospitals...
My gastro guys site has at least 20 prep/recovery bed stations and they’ve been at about full capacity in the time I spent there. Size comparable to big hospital OR.
Pill cam for small intestine is an amazing thing...like a large gel cap with video cam transmitter...swallow, they get the pictures and later down the toilet it goes. Totally pain and discomfort free.
Thanks for the data/info.
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.