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Earlier Colon Cancer Screening?

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Earlier Colon Cancer Screening? May 15, 2008 -- On your 50th birthday, you'll get a present from your doctor -- a referral to colon cancer screening, preferably by colonoscopy.

But a new study suggests this gift might do more good if it arrives years earlier.

Most people don't get colon cancer before they're 60. Although colon cancer is deadly, it takes about a decade for colon polyps to turn into cancer (if they do -- most polyps never become cancers). Removal of polyps prevents colon cancer, so doctors start looking for polyps when a person turns 50.

Should doctors start looking earlier? A new study shows that people in their 40s are just as likely to have colon polyps as are people in their 50s. Study leader Alfred I. Neugut, MD, PhD, is acting chief of oncology at Columbia University Medical Center.

"Should we start screening people in their 40s? Maybe," Neugut tells WebMD. "It does take 10 years for a polyp to turn into cancer. So if people had screening in their 40s, maybe you would not see cancers in people in their 50s."

Neugut is quick to point out that this small study is by no means definitive. For one thing, there were too few patients. And the study did not evaluate whether the patients had family histories of coloncancer -- a risk factor for colon cancer that should trigger screening before age 50.

(Have you been screened for colon cancer? How old were you when you had your colonoscopy? Talk with others on WebMD's Active Aging message board.)

The study looked at colonoscopy results from 553 people aged 40 to 49 and from 352 people aged 50 to 59. All of these people received colonoscopies as part of a corporate health-screening plan.

The results:
  • 14% of 40-somethings and 16% of 50-somethings had one or more polyps.
  • 2% of 40-somethings and 3.7% of 50-somethings had a polyp that was becoming cancerous.
  • None of the 40-somethings and one of the 50-somethings had colon cancer.

"I see colon cancer patients, and I see a lot of 52- and 53-year-olds," Neugut says. "If we had caught their polyp when they were 47, I would not be talking to them when they were 52. I can't say that this study should lead to a change in screening policy, but we should consider it. Maybe we could compromise and say people should start screening at age 45."
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