The national colorectal cancer rate is dropping in part because more people are getting screened. Some screening tests can find polyps, or pre-cancers that can be removed before becoming cancerous.
But for adults under 50, rates are increasing. If the trend continues, MD Anderson Cancer Center researchers estimate that by 2030, rates of colon cancer will increase by 90 percent and rectal cancer will increase by 124 percent among adults ages 20-34.
In 2018, the American Cancer Society lowered the recommended age to begin screening from 50 to 45. The Prevent Cancer Foundation® supports that recommendation and is working to improve awareness of the issue and encourage action.
Creative messaging that appeals to a younger audience is critical to raising awareness and inspiring action. The Foundation launched a public awareness campaign in 2019 called “Too Young for This Sh*t” that uses cheeky graphics to educate adults under 50 about the disease.
Younger adults who are diagnosed may have a family history of colorectal cancer or polyps, or a personal or family history of inflammatory bowel disease. The campaign also brings attention to lifestyle choices that can reduce risk, such as maintaining a healthy weight, being physically active, limiting red and processed meat, never smoking, and drinking alcohol in moderation, if at all.
New screening technology
The good news is that improvements in screening are driving hope in colorectal cancer. The colonoscopy has been the gold standard for decades. Now, at-home stool tests—the guaiac-based fecal occult blood test (gFOBT), fecal immunochemical test (FIT), and FIT-DNA test—are about as effective as colonoscopy at reducing mortality if done as recommended (every one to three years depending on the test, with a colonoscopy recommended every 10 years) and if abnormal results are followed up with a colonoscopy.
Research shows people are more likely to get screened for colorectal cancer when offered a variety of options for screening. At-home tests allow more flexibility for those who are deterred by colonoscopy prep or who face barriers to colonoscopy appointments, such as work, family obligations, or unreliable transportation. For those without insurance (which covers colonoscopy), they are more affordable.
Despite the improving screening rate among adults ages 50-75, the Centers for Disease Control and Prevention (CDC) reports about 25 percent of adults within this range still haven’t been screened. It will take more time and effort from health care professionals, policymakers, and advocates, as well as patient buy-in, for screening rates to reach the levels we’d like to see.
Innovation in cancer screening is making early detection more accessible around the world. People in under-resourced areas may face obstacles, including financial, logistical, and cultural, but technology and innovation are transforming the ways patients can be reached.
Cervical cancer could be virtually eliminated with widespread human papillomavirus (HPV) vaccination and screening with Pap and HPV testing, since most cervical cancer cases are linked to HPV. Although the Pap test is not a new tool in early detection, it’s not accessible for all; the Prevent Cancer Foundation has funded grants in countries such as Peru and Cameroon to evaluate the use of mobile low-cost technology for screening in remote areas.
Breast cancer screening has improved over the years with digital mammograms and MRIs, but again, underserved patients often lack access to these resources. Memorial Sloan Kettering Cancer Center researchers received a Foundation grant to screen high-risk women in Nigeria using both traditional screening and the more cost-effective iBreast Exam, a hand-held portable device.
Screening saves lives
Low-dose CT screenings for lung cancer are a precise way to measure early-stage lesions, when a surgical cure is possible. Despite coverage by public and private insurance, uptake still sits at an abysmal 5 percent in the United States. Fewer people are smoking and dying from lung cancer overall; better education and awareness of screening could improve screening rates and save more lives. The Foundation is funding a group of computer scientists developing tools to optimize CT scanners and detect lung cancer early in a cost-effective way.
As doctors and researchers work to further advance cancer screening, early detection can become a reality for more people.