Why the medical community recommends exams at 50 and older?

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MayinLA
Posts: 1
Joined: Sun Oct 18, 2015 9:26 pm

Why the medical community recommends exams at 50 and older?

Postby MayinLA » Tue Oct 20, 2015 1:56 pm

HI everyone, I've been a reader of this group for almost 2 years, but this is my first post. My sister was DX with stage IV CRC in November 2013 at age 38. A year prior a former intern was DX with stage IV CRC at age 28. He's in remission now...yay! I've learned quite a bit about this disease through this forum and I've come to realize that far too many young people are being diagnosed with this dreadful illness. My question is why is the medical community still recommending that we have your first colonoscopy exam at age 50? I just don't get it. Over the summer I was with a friend who was visiting from Germany and she informed me that they recommend exams beginning at age 35. Also, due to her digestive complications as a child she began having colonoscopy exams at age 10 and she has them every other year. I make every effort to share what I know and encourage all adults to get an exam regardless of if they have any symptoms or complications, but I believe that we really need to change the recommendations made by the medical community. This forum has really opened my eyes and this disease has no age limit....

sjring
Posts: 181
Joined: Mon Jun 30, 2014 3:16 pm
Location: Philadelphia, PA

Re: Why the medical community recommends exams at 50 and older?

Postby sjring » Tue Oct 20, 2015 4:10 pm

Its a good question, and one I was just discussing with a friend of my wife's who does market research for a health insurance company.

It basically comes down to statistics. 90% of CRC cases are still dx in the >50 population. There are cases where there is recommendation for colonoscopies for those under 50. If a direct relative is dx, then you should be tested 10 years earlier than the age at which that relative was dx. For example, I was dx at age 48 so my children should begin screening at age 38.

I think there should be at least consideration of other risk factors (my personal feeling). For example, I was a gastric bypass patient. There's more and more evidence of higher CRC risk in the GBP population, so I personally think there should be guidelines for screening for that group (probably 3-5 years post-surgery but there probably needs to be more research into that).

I am aware there are some petitions going around to lower the recommended screening age to 40.

And I also think it's up to people like us, those with the disease and caregivers to make people aware of the symptoms, and urge people to request screening when they have them. I think it's also important for us to debunk the social stigma associated with colonoscopies to the extent we can. There's a lot of resistance to the procedure.

For those interested, FightCRC's annual Call-on-Congress event is now open for registration for 2016 (http://www.CallOnCongress.org). I went for the first time this year and found it very rewarding to be able to meet with my elected representative (more often their staff but staff are the movers and shakers), tell my story with other advocates and help to influence policy.
50 YO Husband & father of 2 teenagers.
DX 9/9/13 Stage 4 cc (at age 48)
16 Rounds FOLFOX + Avastin (Oct-13 to May-14)
Maintenance chemo - Avastin & 5-FU infusions (Jun-14 to Jul-15)
Jul-15: Mets to lymph nodes, resuming FOLFOX
Sep-15: MRI showed stability, back to maintenance chemo.

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NZJay
Posts: 640
Joined: Mon Dec 16, 2013 3:00 pm
Location: NZ

Re: Why the medical community recommends exams at 50 and older?

Postby NZJay » Tue Oct 20, 2015 4:51 pm

Even though standardised screening for young people would seem irrational, it would be great to see the medical community pay closer attention to the POSSIBILITY colon cancer can occur in <50 year olds.

I remember when I first presented to the GP about this. Two months later they were still certain I had a combination of a nasty virus and hemorrhoids. It took a "well let's just do one for the sake of it" CT scan before they recognised a massive tumour in my colon and stomach.

I also remember the GP joking "don't worry Jay, you don't have cancer!"

I know cases like mine are unexpected. But at least pay attention to the POSSIBILITY when we present with symptoms. Symptoms shouldn't be disregarded simply due to age.
11-13 Dx CC
SPS T4b(touched stomach organ),N1(3/23),M0(Stage 3B)
11-13: resect + partial gastrect
2-14: 1 Tx Cape + Oxy; renal failure, colitis
4-14: 7 Tx Capecitabine
1-15: clear CT
7-15: clear scope
1-16: clear CT
3-17: clear CT
10-17: clear scope (5 year gap now!)
CEA@dx: 8.4 / 6-15: 4.0 / 10-15: 4.2 / 2-16: 4.9 / 7-16: 4.9 / 11-16: 5.0 / 6-17: 4.5
NED since resection

JDinNC
Posts: 771
Joined: Fri Jul 05, 2013 9:49 pm
Location: Murphy, N.C.

Re: Why the medical community recommends exams at 50 and older?

Postby JDinNC » Tue Oct 20, 2015 5:01 pm

Since coming to this forum two years ago, I've notice so many young people with colon cancer. We are all here for the fight against cancer so I agree early screening would make such a different. So many saved lives...!!

The sad part...young people think they are invincible and it won't be until there are symptoms before they will do anything. My own son who knows the seriousness of the disease and who will be turning 40 in two weeks. Has promised me to get a colonoscopy as my Christmas gift from him but I'm sure he will keep putting it off... :(

My own doctor never offered me a colonoscopy when I was in my 50's even when I repeatedly told him my symptoms. He just kept telling me I had IBS
61 y/o female @ DX...........
T3N0M1
6/13 DX- stage 4
Sigmoid colon cancer.
One met to lung
7/13 colon resection
8/13 lung resection
7/17 four years....NED
8/18 five years....NED
MELANOMA
63 y/o @ DX
6/15 stage 2a
7/15 surgery on arm
7/15 NED
4/16 recurrance
5/16 remove metastasis from back
5/16. Started immunotherapy
8/16 discontinue treatment
7/18...PET scan...NED

Lisa90
Posts: 50
Joined: Tue Oct 13, 2015 4:26 pm

Re: Why the medical community recommends exams at 50 and older?

Postby Lisa90 » Thu Oct 22, 2015 1:25 am

I complained of symptoms for exactly a year before they decided to do a scope, at which point my colon was almost completely constricted by the tumor I had.

I was told for that whole year that I had IBS or that I was lactose intolerant; I was given a whole host of anti-virals and parasite killers, they even put me on antidepressants to see if that helped my symptoms!

I had been asking my oncologist (whom I was still seeing regularly for follow ups) about my symptoms, too, and when I specifically asked about colon cancer he laughed it off; saying there's not really a chance I have that. When I came into his office after my scope and the colectomy, I'd never seen anyone turn so pale.

I have been asking as many doctors as I can come across why I can get diagnosed with CC at 24, but all they tell me is that it's very, very rare for patients below 50, let alone below 30.

I understand I personally am at higher risk of getting cancers I shouldn't because of all the chemo I've had and the rad I had when I was little, but it would be nice to get an answer besides, as my one doctor put it, that my body "obviously doesn't read the textbooks".

I'm going for gene testing soon to see what exactly is up with my body and cancer; if they manage to find something out with regards to why I got CC so young, I will definitely share!

Edited for more info
25y/o F
Symptom onset Aug '14
Colonoscopy done 1 Sep '15
Emergency colectomy done 2 Sep '15 due to obstructing tumor
DX CC stage IIIB - Sigmoid Colon (Adenocarcinoma)
FOLFOX started 13 Oct '15
Oxaliplatin dropped at treatment 9
Treatment completed 5 May '16
Li-Fraumeni syndrome confirmed

Previous history:
- Rhabdomyosarcoma ('92) Right leg
- Osteosarcoma ('01) Right leg
- Osteosarcoma ('12) Left leg (recurred '14)

Nik Colon

Re: Why the medical community recommends exams at 50 and older?

Postby Nik Colon » Thu Oct 22, 2015 2:00 am

Article date: March 16, 2015

By Stacy Simon

Thanks in part to improvements in screening, the rates of new colon and rectal cancer diagnoses have been falling in the United States for people ages 50 and older. But for people under 50, for whom routine screening is not recommended, rates seem to be increasing significantly.

Researchers from The University of Texas MD Anderson Cancer Center looked at data from more than 393,000 people diagnosed with colon or rectal cancer between 1975 through 2010 who are part of the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) registry. Based on current trends, they predict that by 2030 the incidence rates among people ages 20 – 34 years will increase by 90% for colon cancer and by 124.2% for rectal cancer. Among people ages 35 – 49 years, they predict the incidence rates will increase by 27.7% for colon cancer and by 46% for rectal cancer.

"The increasing incidence of colorectal cancer among young adults is concerning and highlights the need to investigate potential causes and external influences such as lack of screening and behavioral factors," say the study’s authors. They note that obesity rates have increased significantly in the United States, and obesity is a major risk factor for colon and rectal cancer.

The study was published in the January 2015 issue of JAMA Surgery.

http://m.cancer.org/cancer/news/news/co ... ung-adults
Last edited by Nik Colon on Thu Oct 22, 2015 2:19 am, edited 3 times in total.

User avatar
Mastan
Posts: 433
Joined: Sat Feb 19, 2011 11:12 am
Location: Albuquerque, NM

Re: Why the medical community recommends exams at 50 and older?

Postby Mastan » Thu Oct 22, 2015 8:51 am

It is probably about the $. Statistically it is rare to develop CRC below the age of 50. So from the insurance industry perspective, why should they pay for wide spread colonoscopies for that part of the population for which findings would be rare? It would add a lot of cost to the insurance companies with little benefit. From my perspective the practical thing that we can do is to educate friends, family, and even primary care doctors about symptoms of CRC.

Mark
Dx 6/2010 rectal CA

Nik Colon

Re: Why the medical community recommends exams at 50 and older?

Postby Nik Colon » Thu Oct 22, 2015 10:47 pm

Mastan wrote:It is probably about the $. Statistically it is rare to develop CRC below the age of 50. So from the insurance industry perspective, why should they pay for wide spread colonoscopies for that part of the population for which findings would be rare? It would add a lot of cost to the insurance companies with little benefit. From my perspective the practical thing that we can do is to educate friends, family, and even primary care doctors about symptoms of CRC.

Mark

Oh, I'm pretty sure money is the reason, but because it's on the rise, they should at least provide more info and knowledge and focus on telling younger people about the symptoms if they aren't going to lower the age. It may have been there b4, but I don't recall ever hearing anything about CRC, so like breast cancer, they need to get the word out there more.

booharvey
Posts: 1
Joined: Tue Oct 27, 2015 9:38 pm

Re: Why the medical community recommends exams at 50 and older?

Postby booharvey » Wed Oct 28, 2015 1:46 pm

My husband was diagnosed with Stage III CRC on 3 Aug 15. He is 43 years old. He does not know his biological father so he does not have that side of his history. Three years ago he went in for chronic diaharrea, feeling to go but can't, or going but still feeling like he had to go. He self diagnosed himself with lactose intolerance. He says he thought there was blood but wasn't certain. I recently got copies of the doctor notes, and it says all his symptoms but it also says "pt states no blood in stool." So they did a fecal test, but never tested it for blood. It blows my mind that they would test his stool and not test for blood. His note also said he was refered to GI but was never told. Now, 3 years later he has CRC. I beyond frustrated. I have been getting colonscopies since I was 35 because of my family history and also IBS. I am kicking myself for not making him get tested earlier. After reading all these post on here, I am blown away by how many young people have been dx. Something needs to change. Fecal test should be done starting at 20 years old to detect if there is blood or not and if there is than further testing required. It absolutely blows my mind. I am frustrated with the whole process. As the patient, I feel you need to know every possible test there is and demand that you get tested. Why not rule out the worst case first versus down playing it based on someones age.


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