Colorectal Trends & Screening Guidelines
Approximately 150,000 new cases of colorectal cancer are diagnosed each year. Colorectal cancer is the third leading cause of cancer deaths in the United States. Know your risk factors and get familiar with how you may be able to prevent colorectal cancer. While colorectal cancer poses a serious health risk to many, the good news is that screening, diagnosis and treatment are getting more effective.
Promising Trends in Detection and Treatment
Recent trends in screening and advancements in treatment are leading to fewer deaths from colorectal cancer.
- Colorectal cancer incidence and mortality rates among adults 50 and older have declined by more than 30 percent in the U.S. over the past fifteen years, largely due to screening.
- More than 1.45 million colorectal cancer survivors are alive in the U.S. today, more than at any other time.
- Screening is detecting colorectal cancer at earlier stages. The earlier the disease is caught, the better chance a person has of surviving at least five years or longer. Today roughly 39 percent of colorectal cancers are found at the local stage, and the 5-year survival rate for these patients is nearly 90 percent.
- Promising new targeted therapies are being studied in clinical trials for first, second and third-line use in patients with metastatic colorectal cancer.
- Researchers are discovering the important role lifestyle plays in prevention, as several studies have found that exercise and a diet low in meats and high in vegetables can reduce colorectal cancer risk.
Screening Saves Lives
The U.S. Preventive Services Task Force (USPSTF), an independent panel of national experts in evidence-based medicine and disease prevention, has found convincing evidence that screening in adults aged 50 to 75 years reduces colorectal cancer mortality.8 Not only is screening by sigmoidoscopy or colonoscopy successful at detecting existing colorectal cancer, these direct visualization tests also find abnormalities, such as polyps, that may be precursors to cancer. While other cancer screening tests, such as a mammography, only find cancer that is already established in the body, sigmoidoscopy and colonoscopy catch abnormalities before they turn cancerous—playing a key role in cancer prevention.
According to the National Colorectal Cancer Roundtable, if screening remains at the current level, roughly 40,000 additional colorectal cancer cases and over 37,000 deaths will be prevented through 2030.
Over 60 percent of deaths from colorectal cancer could be avoided with screening
Providing Screening Options May Increase Participation.
Although screening numbers for colorectal cancer are increasing, there is still much work to be done, as about one-third of eligible adults in the U.S. still have not been tested.12 Many people shy away from getting a colonoscopy because the test is invasive, unpleasant, and carries a certain amount of risk. For those patients, other screening methods, such as stool-based tests and virtual colonoscopies, may be more attractive options. According to the USPSTF, there are no head-to-head studies demonstrating that any one of the screening strategies is more effective than another, although each test has different strengths and limitations. There is no one test that is right for every patient, so healthcare providers should be prepared to discuss all screening options. At the end of the day, the best test is the one the patient will actually take.
Screening Guidelines Comparison
Recommendations for colorectal cancer screening vary depending on the organization issuing the guidelines. The chart below shows a side-by-side comparison of guidelines from the U.S. Preventive Services Task Force, The American Cancer Society and the American College of Physicians.