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The US Task Force proposes to start screening for colorectal cancer at the age of 45



New York (CNN)-the United States Preventive Services Task Force-the leading medical steering group in the United States-is considering a draft recommendation to reduce the recommended age for screening for colon and rectal cancer to 45 years.

Previously, it was recommended to start screening at the age of 50.

“This new draft proposal (we are seeking feedback) is that all adults between 45 and 75 years of age should be screened for colorectal cancer. For some older adults, the age of 76 to 85 should be Screening depends on their overall health and past screening patterns.” Working group member Dr. Michael Barry told CNN on Monday.

The working group released the draft proposal online on Tuesday, and plans to accept public comments on the draft before the final draft of the proposal is finalized in the next few months.

The draft proposal will not affect insurance coverage, but if it is finalized, the final proposal will mean that according to the current law, most private insurance plans can cover colorectal cancer screening services, and for patients between 45 and 75 years old , You don’t need to pay out-of-pocket recommendations.

The draft proposal recommends that all adults between 50 and 75 years of age should be screened for colorectal cancer as “A”

;, but the recommendation for adults between 45 and 49 years old is “B”.

Barry said: “A and B’s recommendations mean that we believe that clinicians and patients should do the same.” “For practical purposes, they are actually the same in terms of actions.”

However, “the difference is related to how we view the evidence. There is greater evidence that adults between the ages of 50 and 75 have benefited from adults between the ages of 45 and 49. We are more certain about this, so these are the two different levels of reason,” Barry said.

The draft recommendation is based on emerging epidemiological data, indicating that the risk of colorectal cancer is increasing among young people aged 45 to 49 years. This rising risk recently attracted worldwide attention when the “Black Panther” star Chadwick Boseman died of colon cancer in August. . He was 43 years old.

In addition to examining epidemiological evidence, Barry also said that the task force commissioned a set of simulation models to study issues related to colorectal cancer screening.

Barry said: “The simulation model does support the epidemiological data, showing that although we benefit from people aged 50 to 75, we can prevent some additional colorectal cancer deaths by starting screening at the age of 45.”

The draft evidence review and the draft modelling report were also posted online on Tuesday, accompanied by a draft recommendation statement. The public is invited to comment on the draft proposal before November 23.

This is not the first time that a 45-year-old has been considered for colon and rectal cancer screening. The American Cancer Society has updated its colorectal cancer screening guidelines, starting at the age of 45 instead of the previously recommended 50. The update took place in 2018.

However, the USPSTF did not follow suit.

“Obviously, the U.S. Preventive Services Task Force has now revisited all the data available there, and they have conducted modeling studies to study how to formulate and determine these guidelines, and they have now determined this based on newly emerging data. Regarding the growth of this situation among young people, it does make sense now, and it is likely that screening will start at the age of 45 to bring huge benefits,” Kimmie Ng, medical oncologist and director of the Center for Young Onset Colorectal Cancer Said the doctor. Dana Farber/Brigham Women’s Cancer Center in Boston.

In response to the increase in colon and rectal cancer cases among young people, the Young Onset Colorectal Cancer Center was established last year. Some of the center’s research focuses on answering questions about why this growth occurs.

Ms. Wu, who did not participate in the task force’s recommendations, emphasized that there are also ethnic differences in the incidence and mortality of colorectal cancer-black adults are more likely to develop the disease at a young age and are more likely to die from the disease-early screening may help Narrow the racial gap.

Ng said: “Therefore, it is hoped that by starting screening of all moderate-risk Americans as soon as possible, we may be able to make some progress in reducing these gaps.”

Mr. Wu said: “In general, we will definitely see that young people are often in the late stage of the disease at the diagnosis stage of colorectal cancer, and there are no obvious risk factors.” “We do see so many young people being diagnosed. The fact that people are under 45 years of age does show that people still need to continue to study the underlying causes.”

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