As colorectal cancer trends younger, awareness and prevention saves lives Midlands Voices: As colorectal cancer trends younger, awareness and prevention saves lives

The incidence rate of colorectal cancer has more than doubled among adults younger than age 50 since the 1990s. More younger people are dying from the disease.

Between 2013 and 2017, for individuals ages 50 to 64, the incidence of colorectal cancer dropped about 1% per year. It is felt that increased screening in that age group has been largely responsible. Over roughly the same time, the incidence for individuals under age 50 increased by 2% per year. Because of these trends, the American Cancer Society (2018) and the United States Preventative Services Task Force (2021) have lowered the recommended screening age for colorectal cancer from 50 to 45.

Screening refers to tests done on individuals with no symptoms. Colorectal cancer frequently has no symptoms until it is advanced, challenging to treat. Screening can be done with stool tests (hidden blood, DNA) or by colonoscopy. Stool tests primarily identify early cancers while still treatable. Colonoscopy can prevent cancers by removing pre-cancerous polyps.

Colorectal cancer screening is often placed on the back burner for many reasons. Some of the most prominent barriers to screening are a lack of education and an abundance of misconceptions about colorectal cancer prevention. For example, some think colorectal cancer only affects men. Others have heard misinformation about colonoscopy being painful.

The reality of screening is the opposite of what most people think going into the process. Usually, when patients wake up from a colonoscopy, the first thing they ask is, "When are we going to start?" Or they'll say, "That's it? That wasn't so bad." The fact is, for those who have had the experience, colorectal screening is just one small step they've taken in their quest for a long, healthy, happy life.

Unfortunately, some still suffer in silence because they feel unnecessarily ashamed to share their struggle due to social stigma. However, colorectal screening is just as crucial to your health as breast cancer screening, blood sugar testing for diabetes or testing your cholesterol to protect against heart disease. Colorectal cancer incidence and mortality rates are higher in Nebraska when compared to other states. Screening rates are lower. As physicians and leaders of the Nebraska Cancer Coalition and Great Plains Colon Cancer Task Force, we have been collaborating with State Legislators to continue to remove barriers to colorectal cancer screening for Nebraskans. We encourage the Legislature to amend current state law to officially reflect the national recommendation to begin colorectal screening at age 45.

We also are teaming up with our partners in the health insurance industry to ensure that Nebraskans needing colonoscopy after a positive stool test will have full insurance coverage as a necessary part of their screening examination.

Colorectal cancer is the second most lethal type of cancer in the U.S. We all need to have conversations with our doctors and loved ones to do everything we can to prevent this disease. This includes being open about and encouraging screening.

March is National Colorectal Cancer Awareness Month, and this year marks a unique awareness challenge. The ongoing pandemic has resulted in millions of postponed or canceled screening appointments. But that doesn't postpone or cancel the possibility of a cancer diagnosis; it only makes it harder to fight back.

Do not delay cancer screening any longer. We encourage healthy adults over the age of 45 to make this Colorectal Cancer Awareness Month a reminder to schedule or reschedule screening as soon as possible. Put simply, you don't know if you don't go!

Dr. Alan Thorson, FACS, is the chair of the Nebraska Cancer Coalition, a statewide, non-profit organization of over 200 organizations comprised of local health departments, cancer centers, medical associations, health systems and individual medical providers.Dr. Josh Evans is board certified in gastroenterology and hepatology. He has been with Midwest Gastrointestinal Associates since moving back to Omaha in 2011 and has served as the president of the Great Plains Colon Cancer Task Force since 2014.