Younger Age for Bowel Screening

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Sydney, Oct 23: In a significant development, the National Health and Medical Research Council (NHMRC) has recently endorsed updated clinical practice guidelines, marking a crucial milestone in Bowel Cancer Australia’s five-year campaign.
These guidelines recommend a lowering of the bowel cancer screening start age and expansion of screening efforts.
For the first time, population screening (for individuals at average risk of developing bowel cancer, without any symptoms) is now recommended every two years for people aged 45-74 (previously 50-74). Additionally, the National Bowel Cancer Screening Program (NBCSP) start age has been lowered from 50 to 45.
Furthermore, individuals aged 40-44 (previously 45-49) now have the option to request screening through their healthcare professional before receiving their first NBCSP invitation.
Bowel Cancer Australia’s tireless advocacy and support from passionate advocates have contributed to this significant update.
Currently, 1,716 Australians are diagnosed with bowel cancer under the age of 50 each year, with people aged 40-49 accounting for 56 percent of new cases and 64 percent of deaths in those diagnosed under 50.
Julien Wiggins, CEO of Bowel Cancer Australia, emphasized the need for the Federal Government’s approval, funding, and implementation of a lower NBCSP screening start age to prevent early-onset bowel cancer deaths.
He also stressed the importance of healthcare professionals implementing the updated guidance for individuals aged 40-44.
The recommendation to begin screening from age 45 mirrors similar guidelines introduced in the United States in 2018.
In response to rising rates of bowel cancer incidence and mortality in young and middle-aged populations, the American Cancer Society (ACS) updated their guidelines, later followed by the American College of Gastroenterology (ACG), the US Preventive Services Task Force (USPSTF), and the US Multi-Society Task Force (USMSTF) on Colorectal Cancer (CRC).
However, A/Prof Graham Newstead AM, Medical Director at Bowel Cancer Australia, highlighted that while lowering the screening age is a step forward for individuals aged 40 and over, it does not address the increase in early-onset bowel cancer.
The reasons behind younger people developing bowel cancer are still not fully understood.
Nevertheless, research has indicated that individuals under 50 are at increased risk of developing bowel cancer when they experience specific symptoms, including abdominal pain, rectal bleeding, diarrhea, and iron deficiency anemia between 3 months and 2 years prior to diagnosis.
A/Prof Newstead stressed the importance of younger people being aware of these potential signs and symptoms and promptly seeking medical evaluation.
Recent Australian research has demonstrated that self-advocacy is a consistent and reliable resource for overcoming age bias, and diagnosis barriers, and optimizing outcomes for bowel cancer, which remains the deadliest cancer for those aged 25-44.
Bowel Cancer Australia’s Never2Young Advocacy Agenda aims to enhance care experiences and health outcomes for younger people by focusing on various key aspects, including raising awareness of early-onset bowel cancer, lowering the screening age, ensuring prompt GP referral for symptomatic individuals, improving pathways for timely diagnosis and treatment, enhancing understanding of the challenges associated with early-onset bowel cancer, and promoting further research into the causes of the disease.
#N2Y Advocacy Agenda: Bowel Cancer Australia’s Never2Young Advocacy Agenda seeks to improve care experiences and health outcomes for younger people by championing:

  1. Greater awareness: among the community and health professionals of early-onset bowel cancer.
  2. Lower screening age: in response to the increasing rates of bowel cancer in younger people.
  3. Prompt GP referral: to a colonoscopy for all younger people who present with symptoms that may be consistent with bowel cancer.
  4. Improved pathways: that ensure timely triage, diagnosis, and treatment for younger people.
  5. Better understanding: the challenges of early-onset bowel cancer to improve and tailor treatment, support, and care for younger patients.
  6. Further research: into the causes of early-onset bowel cancer, has the potential to improve survival and/or help build a path toward a cure.

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