|Articles|June 6, 2018

A Watershed Moment for EAO-CRC: ACS Drops Screening Age to 45

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Key Takeaways

The ACS recommendation to begin average-risk CRC screening at age 45 formalizes recognition of early-age onset CRC as a widespread epidemiologic trend rather than an anomaly.
A substantial disease burden sits in the 45–49 cohort, representing 43% of early-onset CRC, positioning earlier screening as a high-yield population intervention.
Registry-based data show sharply increasing incidence of colon and especially rectal cancer among individuals under 50, with most cases clustered in the 40–49 bracket.
The NCCRT/CCF Risk Assessment and Screening Toolkit is intended to improve detection pathways for patients <50 and those with family history or hereditary predisposition.
Combining earlier screening with risk-stratification resources is positioned as a strategy to reverse rising early-onset CRC incidence while highlighting ongoing gaps in prevention and implementation.

It was the drop heard 'round the colorectal cancer world.

On Wednesday the American Cancer Society released a study in CA: A Cancer Journal for Clinicians recommending that colorectal cancer screenings should begin at age 45 - instead of age 50 - for those at average risk. The Colon Cancer Foundation has been in the trenches, championing research into the alarming rise of early-age onset colorectal cancer (EAO-CRC)for over a decade; so for us and so many other organizations and individuals in this fight, this is a watershed moment that is going to have a profound impact on the colorectal cancer landscape.

This is the first time that a prominent cancer organization has officially recognized that EAO-CRC is no fluke but a tragic and universal phenomenon that needs to be addressed immediately. 43% of EAO-CRC cases occur in those aged 45-49. If this new guideline becomes the norm, an estimated 22 million Americans can be screened, and thousands of lives will be saved.

As Dr. Thomas Weber, our founder and President, stated in an interview with The New York Times, "This is a very, very big deal. Solid epidemiological data from our national cancer registries documents a dramatic increase in the incidence of colon and especially rectal cancer among individuals under the age of 50, and the vast majority of those cases are in the 40- to 49-year-old age bracket.”

The adoption of the revised ACS screening guideline will be a major step toward reversing the upward trend of EAO-CRC cases. In addition, physicians will soon have the added support of the Risk Assessment and Screening Toolkit - the brainchild of CCF and the National Colorectal Cancer Roundtable (NCCRT). This toolkit was presented by Emily Edelman of the Jackson Laboratory at our 4th Annual EAO-CRC Summit held in April in NYC. It has been designed to give physicians much-needed resources and support to properly detect and treat colorectal cancer in those individuals with a family history of the disease; hereditary predispositions; as well as those under age 50.

We are hopeful that the powerful combination of the new ACS screening guidelines and the Risk Assessment and Screening Toolkit will help shift the tide of EAO-CRC. But there is still much work to be done. To learn more about the new ACS guidelines, click here. You can find more information about the 4th Annual EAO-CRC Summit here. To make a donation or get involved with CCF, please contact us!