"45 is the new 30" and yes, increasingly many trends allow us to forestall looking (and acting) middle aged.
But, even if you feel 30 (congrats!), remember young people still die from cancer.
Thankfully this happens less often than it did 25 years ago–with one MAJOR exception...
>300k patient JAMA cohort study from Canada reveals countless insights summarized best in the figure below.
Remember, cancer mortality is determined by a.) risk factors, b.) screening/early detection, and c.) efficacy of treatment (and undeniably SDOH...)
Colorectal cancer (CRC) deaths (#2) are the ONLY cause of cancer related death increasing (~1% per year on average since 2000) and are likely to exceed breast cancer deaths (#1 currently) soon if the trend isn't mitigated. Here is a chart simplifying the data into a clear visual (check out the research article for more data and visuals).
Why is this?
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Delayed detection: CRC symptoms are vague and often mild until the disease has metastasized
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Uncertain risk factors: unlike cancers of the lung, esophagus, cervix etc., we don't have a great handle on what the modifiable risks of colon cancer are
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Less Progress in treatment: immunotherapies have dramatically altered the mortality of subsets of certain cancers (see melanoma and lung cancer curves below)
The most effective treatments for colorectal cancer remain of the more toxic, less targeted variety (and haven't seen dramatic improvements in awhile).
So, why am I sharing this?
Well gotta pass the time somehow through the GoLytely prep (jk-maybe?).
*Importantly, 45 may feel very different than 50 psychologically, but biologically it's not.*
The knowledge/guideline-practice gap (est. to be 17 years!) means, many older millennials (ie, born in the early 80's!) are already overdue for colon cancer screening!
And many patients in the their 40's don't have a primary care relationship and remain unaware of guideline updates. These folks worry me the most.
To put it simply, *45 years old is the OLDEST age where colon cancer screening should start. With concerning family history of cancer and/or inflammatory bowel disease, screening should start sooner.*
The most recent screening guidelines are here.
Share them with anyone who remembers the show Alf and hasn't had any screening yet.
Thanks to Andy Barnett, Lauren Wiebe, Kiran Turaga and my many other colleagues working to reverse this trend!
Read the full research article here: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2852900
