This week, Bobbi Conner talks with Dr. Thomas Curran about the increase in colon cancer in younger adults and options for screening. Dr. Curran is an Associate Professor of Surgery and a colorectal cancer surgeon at MUSC Hollings Cancer Center.
TRANSCRIPT:
Conner: I'm Bobbi Conner for South Carolina Public Radio with Health Focus here at the radio studio for the Medical University of South Carolina in Charleston. Colorectal cancer has become more common in adults under the age of 50. Doctor Thomas Curran is here to talk about the increase in this type of cancer in younger adults, and also provide recommendations for screening. Doctor Curran is an Associate Professor of Surgery and he's a colorectal cancer surgeon at MUSC Hollings Cancer Center. Doctor Curran, bring us up to date about the incidence of colon cancer now in younger men and women in the U.S. in recent years.
Dr. Curran: We have seen about a one and a half to 3% increase per year in patients who are born in the 80s to the 90s, so this ends up putting them on par with the same risk that folks had in the early 20th century.
Conner: Do we know what is causing this increase in colon cancer in younger adults?
Dr. Curran: No one knows for sure, but there's been a lot of attention paid to the metabolic conditions like obesity and diabetes that we know cause inflammation, and inflammation can cause cancer. So that may be a link that could be responsible. But importantly, not everyone affected with young onset colorectal cancer are obese. They don't have to be diabetic. It really can affect everyone. These are just population level trends that we have observed.
Conner: And from your vantage point, why is colon cancer screening so important?
Dr. Curran: The reason it's so important is because colorectal cancer really doesn't necessarily cause symptoms until it becomes more advanced. And so finding it when it is early requires screening when folks are not having symptoms.
Conner: What are the recommendations for colon cancer screening for those adults at average risk.
Dr. Curran: In light of this observation, where we've seen more young onset disease, the age of screening has moved from 50 down to 45. So 45 is the age for average risk at this point.
Conner: And what are the recommendations for colon cancer screening for those adults that are at increased risk?
Dr. Curran: For those at increased risk, it can depend. So, there are certain genetic predispositions that may start screening as early as their late teens or late adolescents. But in general, for non-genetic predispositions, family history would be to start ten years sooner than the youngest affected family member. So, if you had a family member who had colorectal cancer at age 40, you'd start at 30.
Conner: And what are the options for screening, particularly for somebody now 45 years old?
Dr. Curran: The prevailing professional societies that govern screening have a menu of options. So, these include colonoscopy. They include stool based testing like cologuard or immunohistochemical testing. And then there are radiographic tests like CT colonography, though that is less commonly used.
Conner: And tell us about the new blood test that's being used in some cases as screening for colorectal cancer.
Dr. Curran: There have been some new tests that have come to market in the last few years, one of which is FDA approved. It looks to identify fragments of cancer DNA in the bloodstream. There's a lot of enthusiasm because of how easy blood tests are to do in general, but their effectiveness is not yet really up to the other standards we have, like colonoscopy or stool based testing.
Conner: Doctor Curran, thanks for talking with us about colon cancer and screening.
Dr. Curran: You're welcome Bobbi, always a pleasure to be here with you.
Conner: From the radio studio for the Medical University of South Carolina in Charleston, I'm Bobbi Conner for South Carolina Public Radio.
Health Focus transcripts are intended to accurately represent the original audio version of the program; however, some discrepancies or inaccuracies may exist. The audio format serves as the official record of Health Focus programming.
