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Forty-Five Is the New 50 for Colon Cancer Screening

LHSFNA Management Co-Chairman Noel C. Borck

June is Men’s Health Month, and a great time to check on whether you’re due for any preventive care screenings. One such screening is a colonoscopy, which looks for colon cancer and other health-related concerns. Previously, adults at average risk for colorectal cancer (CRC) were advised to begin regular colonoscopies at age 50.

In 2018, the American Cancer Society lowered the recommended age to begin receiving colonoscopies from 50 to 45 because of the growing number of people under age 50 being diagnosed with and dying from colorectal cancer. While CRC rates have decreased for people over 55 years old, they have climbed 51 percent since 1994 for those under 50. Death rates in this younger group are also rising.

“Many people may have opted to skip important health screenings over the last year and a half due to COVID-19,” says LHSFNA Management Co-Chairman Noel C. Borck. “Now is a great time to take charge of your health by making an appointment with your primary care physician and catching up on health screenings you may have missed.”

Evidence shows several different types of screenings reduce deaths from CRC by detecting precancer and allowing earlier diagnosis of cancer. These tests include:

  • Stool tests: The lab can check for the presence of blood, which can either be a sign of CRC or of non-cancerous growths that can become CRC.
  • Flexible sigmoidoscopy: This procedure looks inside the rectum and sigmoid (lower) colon for abnormalities using a sigmoidoscope (a thin, flexible tube).
  • Colonoscopy: A colonoscope (a thin, tube-like instrument with a light and viewing lens) is inserted through the rectum into the colon. During this procedure, any abnormal tissue seen may also be sampled and removed. Colonoscopy is also used as a follow-up diagnostic test to look for colon cancer if the other tests listed above are found to be positive.

In May of 2021, the U.S. Preventive Services Task Force (USPSTF), an independent volunteer panel of national experts in disease prevention, followed the guidance of the American Cancer Society by lowering its recommendation to begin CRC screenings at age 45 as well. This is significant because most private insurance plans will now have to cover colonoscopies for people age 45 to 75 with no copay for patients.

Adults in their early forties who were already dreading a colonoscopy at age 50 won’t be excited to learn the new recommendation is age 45. However, this is a very important health screening. Outside of skin cancer, colon cancer is the third most common cancer in adults and the second leading cause of cancer deaths in men and women in the U.S.

If you’re between the ages of 45 and 49, review your health insurance coverage before you book your colonoscopy appointment. There may be a lag in time before your health insurance policy updates its coverage to align with the USPSTF’s new recommendation.

Many private insurance plans have already lowered the colonoscopy coverage age to 45, based in part on the 2018 American Cancer Society’s recommendation. For example, I recently turned 45 and my primary care physician recommended I have my first colonoscopy. I reviewed my health insurance summary plan description (SPD) and found that my plan covered colonoscopies beginning at age 45 at 100 percent with no copay. Your health plan may offer similar coverage.

I had my first colonoscopy five months ago and I’m not due for another for 10 years. The experience wasn’t pleasant, but the peace of mind for me and my family afterwards was well worth it.

[Matthew Brown is the LHSFNA’s Health & Welfare Specialist.]

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