A growing body of evidence is prompting calls to lower the recommended age for routine colorectal cancer screening in Canada. The Canadian Cancer Society is urging provinces and territories to reduce the screening age from 50 to 45, citing a concerning rise in diagnoses among younger adults. This shift could significantly improve outcomes, as early detection is crucial in the fight against this often-deadly cancer.
For Michael Groves, 54, of Ottawa, the diagnosis came as a complete shock. In January 2021, he initially believed he was experiencing appendicitis. After a visit to the emergency department ruled that out, he noticed blood in his stool and consulted his family doctor. Though the initial symptoms subsided, his doctor proactively scheduled a colonoscopy for April of that year, given his age. The results revealed a five-centimetre tumour and a Stage 3 colorectal cancer diagnosis. “The idea that it could be colon cancer, that never came to mind,” Groves said in an interview. He underwent surgery to remove a portion of his colon and a six-month course of chemotherapy, taking almost nine months off work.
Groves believes that earlier screening could have led to a less aggressive treatment plan and a better prognosis. His experience underscores the Canadian Cancer Society’s argument that the current screening age is no longer adequate. The organization reports that individuals under 50 are now two to 2.5 times more likely to be diagnosed with colorectal cancer compared to previous generations. This increase necessitates a reevaluation of current preventative measures.
“That growth is something that’s extremely concerning for us and we think that it’s time for governments to react to that so that we can catch more of these cancers early,” said Brandon Purcell, advocacy manager for prevention and early detection at the Canadian Cancer Society.
Currently, routine screening for those 50 and older involves a fecal immunochemical test (FIT), a home-based test that checks for blood in the stool. A positive result prompts a colonoscopy for further investigation. Even as individuals younger than 50 with specific risk factors, such as a family history of the disease or symptoms like blood in the stool, are often offered proactive colonoscopies, the Canadian Cancer Society argues that broader access to FIT testing for those aged 45 and older is essential.
Early detection dramatically improves survival rates. The Canadian Cancer Society states that the survival rate for colorectal cancer is as high as 90% when detected early, but drops to less than 15% in advanced stages. Colonoscopies not only identify tumors but can also detect and remove precancerous polyps, which take approximately eight to ten years to develop into cancer, according to Barry Stein, president and CEO of Colorectal Cancer Canada.
The call for a lowered screening age is supported by recent research. A modelling study published on March 7 in the Journal of the Canadian Association of Gastroenterology estimates that implementing FIT testing at age 45 could prevent 15,070 colorectal cancer cases and 6,100 deaths over the next 45 years. The study, led by Darren Brenner, a professor in oncology and community health sciences at the University of Calgary, also projects potential cost savings of $233 million in cancer treatments, even accounting for the increased costs of testing and follow-up colonoscopies.
Michael Groves also participated in a community conference hosted by Colorectal Cancer Canada in May 2023, sharing his experience as a patient advocate alongside other patients and healthcare professionals. The conference brought together over 200 participants to discuss prevention, treatment, and support for those affected by the disease.
The decision to lower the screening age ultimately rests with provincial and territorial governments. As the incidence of colorectal cancer continues to rise in younger adults, the Canadian Cancer Society hopes that policymakers will act swiftly to implement this potentially life-saving change. The organization emphasizes the importance of proactive measures to combat this increasingly prevalent disease.
What the future holds for colorectal cancer screening remains to be seen, but the growing evidence base and the compelling stories of individuals like Michael Groves are building a strong case for a more proactive approach to early detection. Share your thoughts on this important public health issue in the comments below.
Disclaimer: This article provides informational content about health and medicine and is not a substitute for professional medical advice. Always consult with a qualified healthcare provider for diagnosis and treatment of any medical condition.
