A New Age for Colorectal Cancer Screening

Regular screening now covered at age 45 for some health plans.

According to the American Cancer Society (ACS), colorectal cancer is the third most common cancer diagnosed in the United States. The risk of developing colon cancer is about one in 23 in men and one in 25 in women. In 2022, an estimated 106,180 new cases of colon cancer and 44,850 new cases of rectal cancer will be diagnosed in the United States, and approximately 52,580 people will die from the disease — perhaps, needlessly because colon cancer is one of the most preventable cancers and less likely to cause death if detected early. This is where preventive screening colonoscopies come into play.

Start Young

The death rate from colorectal cancer has been dropping in both men and women for several decades, thanks in great part to regular screening. Colorectal polyps are being found more often during screening and removed before they can develop into cancers, and also, cancers are being found earlier when they are easier to treat. But in the last three decades, the number of colorectal cancer cases in those under the age of 50 has doubled, increasing from 5 percent of total cases to more than 10 percent. For this reason, the United States Preventive Services Task Force (USPSTF) has lowered its recommended age for screening of people at average risk from 50 to 45. Medicare still covers colorectal screening services at age 50.

Thanks to the new USPSTF guideline, private health insurance companies are now required to cover colorectal cancer screenings from age 45 to 75, as mandated by the Affordable Care Act. There are a few caveats though, such as using an in-network provider, so always check your insurance before scheduling any procedure.

Tip: See “Code Colonoscopies With Precision” for guidance on how to code and bill colonoscopies.

Know the Risk Factors

There are several risk factors that raise the chance of getting colorectal cancer — some can be changed, and some cannot. According to the ACS, the links between diet, weight, and exercise and colorectal cancer risk are some of the strongest for any type of cancer. Lifestyle modifications that can lower a person’s colorectal cancer risk include:

Manage a healthy weight;
Stay physically active;
Avoid a diet high in red and processed meats, and include plenty of vegetables, fruits, and whole grains;
Get enough vitamin D;
Don’t smoke; and
Avoid moderate or heavy alcohol consumption.

Of course, there are several risk factors that you cannot change, such as:

Getting older;
A first-degree relative, such as a parent, who has had colorectal cancer;
Type 2 diabetes;
A personal history of inflammatory bowel disease (IBD);
A personal history of colorectal polyps or colorectal cancer;
A family history of colorectal cancer or adenomatous polyps; and
Inherited syndrome (a gene mutation).

Though most colorectal cancers are found in people without a family history of colorectal cancer, it is still important to take family history, and any other risk factors, into account when considering when to begin colorectal screening.

Look for Signs and Symptoms

It is important to know the symptoms of colorectal cancer so you can discuss them with your doctor. Many symptoms can also be caused by other problems, such as IBD, but it is important to get checked if you have any of the following issues:

A change in bowel habits;
A feeling that you need to have a bowel movement that is not relieved by having one;
Rectal bleeding with bright red blood;
Blood in the stool, which looks dark brown or black;
Cramping or abdominal pain;
Weakness and fatigue; and
Losing weight without trying.

Often, colorectal cancer does not cause any symptoms until it has grown or spread. That is why it is critical to schedule regular colorectal screenings.

The Time Is Now

In addition to a healthy lifestyle, regular screening is one of the most important ways to prevent colorectal cancer. If you’re 45 or older, talk to your doctor about which screening test is right for you. And no matter your age, talk to your doctor about your family medical history. People at higher risk for colorectal cancer because of family history or health conditions may need to start screening earlier than age 45.

Resources:

www.cancer.org/cancer/colon-rectal-cancer/about/key-statistics.html

www.medicare.gov/coverage/colonoscopies

www.cancer.org/cancer/colon-rectal-cancer/causes-risks-prevention/risk-factors.html

www.cancer.org/latest-news/signs-and-symptoms-of-colon-cancer.html