Special Update: Colorectal Cancer Screening Guidelines

Podcast Transcript

Scott Steele: Butts & Guts, a Cleveland Clinic podcast exploring your digestive and surgical health from end to end.

Hi, everybody. This is Scott Steele, the Chair of Colorectal Surgery at the Cleveland Clinic in beautiful Cleveland, Ohio. Welcome to a brief little education for all of the listeners out there regarding some of the updated U.S. Preventative Services Task Force recommendations on screening for colorectal cancer.

I think it's important to first start off with everybody understanding that colorectal cancer is the third leading cause of cancer related death for both men and women in the United States. There was an estimated almost 53,000 persons in the U.S. that are projected to die of colorectal cancer in 2021. I think it's also important that people understand that colorectal cancer is most frequently diagnosed amongst persons aged 65 to 74, but almost 10% of patients or more of new colorectal cancer cases occur in persons younger than 50 years of age. More concerning as you've heard a little bit here on Butts & Guts that the incidents of colorectal cancer, unlike some of the older age populations, is actually increasing in those 40 to 49.

It's almost increased by 15% when we go back as little as two decades ago. More concerning is that there's a large percentage of patients out there, eligible adults in the U.S. that have never been screened for colorectal cancer. Our goal is upwards of 80%, ideally 100%. We need to be able to get out there and screen. In the past, we've taken a look and try to maybe see what type of risk you have. If you were at a high risk patient that has a family history, especially for first degree relatives of yours and especially if those first degree relatives were diagnosed at an early age, or you have multiple second degree relatives that have colorectal cancer or those patients that have even a higher risk, such as a history of polyps or history of cancer yourself, or a history of inflammatory bowel disease, or a known genetic disorder that predisposes you to a high lifetime risk, that's the high risk category.

We're talking about simple average risk. You don't have any one of those average risk ones. What we want to be able to do is get you in and get screened. The updated recommendations, they gave it a grade A recommendation for adults aged 50 to 75 to recommend screening for colorectal cancer for all adults aged 50 to 75. That is no change that was before. Here's the change. Adults age 45 to 49 years recommend again, screening for colorectal cancer in this age group. This is new. This is something that has been said in the past, but again, it's an update and we need to be able to do that. Then if you're older, listening to this than 75, so 76 to 85, it's still, if you're healthy and you're doing well and you have this ability to go in and get screened. Again, this is a category C and the evidence indicates that there may be a net benefit to screening all persons in this age group, even though it may be small.

This is where that individual case that you should discuss with your primary care doctor, your gastroenterologist, or your colorectal surgeon that's out there. Again, this is real, and the nice thing about some of these screenings specifically with colonoscopy is that it is something that can be identified in an early stage, a pre-cancerous stage. We can do something about it through the scope. All it does is need you to go ahead and get screened. Whether it's through a stool based test, such as fecal occult blood test, or immunohistochemical tests, whether it's something that is a stool DNA test, or whether it's by a scope itself through the small scope called a flexible Sigmato scope or a colonoscopy, which is really the gold standard out there, go out and get screened.

Do not hesitate. Understand that this is real and it's something that can affect your entire life. We can prevent colorectal cancer, but only if you go out and get screened. To learn more about colorectal cancer or to schedule a colonoscopy here in Ohio, please visit ClevelandClinic.org/colonoscopy. That's ClevelandClinic.org/colonoscopy.

Please remember in times like these, it's important for you and your family to continue to receive medical care. Rest assured here at the Cleveland Clinic, we're taking all the necessary precautions to sterilize our facilities and protect our patients and caregivers. Thank you so much for tuning in to Butts & Guts. That wraps things up here at Cleveland Clinic. Until next time, thanks for listening to Butts & Guts.