Why a rise in colon cancer diagnoses is a good thing: Lisa Jarvis

Key topics:Early colon cancer rates rose in 45-49 age group due to increased screening.Early detection boosts survival to 91% and reduces harsh treatments.Screening remains low; policy shifts risk reversing preventive care gains..Sign up for your early morning brew of the BizNews Insider to keep you up to speed with the content that matters. The newsletter will land in your inbox at 5:30am weekdays. Register here.Support South Africa’s bastion of independent journalism, offering balanced insights on investments, business, and the political economy, by joining BizNews Premium. Register here.If you prefer WhatsApp for updates, sign up to the BizNews channel here..By Lisa Jarvis.New data shows a rise in colon cancer among adults ages 45-49. That’s wonderful news.Celebrating an increase in cancer rates might seem counterintuitive, but it comes amid a push for more screening of adults in this age group. And the result is more tumours are being caught in the early stages when the chances of survival are much higher — around 91%. The data is also validation of the importance of preventive care, which unfortunately is increasingly at risk in the Trump administration.In the last decade, doctors have observed, with growing frequency, patients in their 30s and 40s showing up in their offices with colon cancer—and too often, it is being diagnosed only after the disease had already spread. In 2021, the troubling trend led the US Preventive Services Task Force — an independent group that issues recommendations on preventive care — to lower the recommended screening age for average-risk individuals from 50 to 45.New analyses from the American Cancer Society, published this week in the Journal of the American Medical Association, suggest that this change is already having an impact. Among people in their mid-to-late-40s, colon cancer cases rose sharply between 2019 and 2022, following a modest, steady increase over the previous 15 years. The uptick was driven largely by a surge in early-stage tumours — a promising sign that the updated screening guidelines are working as intended..“It’s so gratifying to see the needle move toward early diagnosis,” says Rebecca Siegel, an epidemiologist and senior scientific director of surveillance for the American Cancer Society.Catching the disease early can significantly improve outcomes.“Finding cancers that are not symptomatic yet — potentially catching them early — is big and important,” says Jeffrey Meyerhardt, codirector of the colon and rectal cancer centre at the Dana-Farber Cancer Institute. “We know colorectal cancer can be cured if caught early.”.Read more:.The Economist: How we’re gradually winning the war on cancer .The hope is to save lives — and also improve them. Early detection might spare patients from some of the worst side effects of treatment, which can be invasive for advanced stages of the disease, Siegel says. For example, an early diagnosis could mean preserving fertility and sexual function.Bringing those benefits to more people remains a work in progress. Although screening rates among 45-to-49-year-olds increased after the guidelines changed, only about a third of this group was up to date on screening by 2023. The medical community is now grappling with how best to encourage more people to begin testing at a younger age. “It doesn’t seem realistic to say, ‘You’re age-eligible, good luck,’” says Joshua Demb, a cancer epidemiologist at the University of California, San Diego. People often need a nudge to pursue any type of preventive screening — but especially when it involves a test with an infamously unpleasant prep.So, what kind of nudge works?A separate study published this week offers some clues. Researchers from UCLA tested four different strategies for encouraging people to get screened. Some participants were mailed an at-home test — known as FIT (fecal immunochemical test) — which tests for blood in the stool. Others received a message through their health care system’s patient portal offering them one of three choices: to take a FIT test, to get a colonoscopy, or to choose between the two.It turned out that people were more likely to follow through with screening when a test simply arrived at their home. The findings are “a little bit sobering,” says Meyerhardt — not just because the mail-order approach worked better than offering people a choice, but also because the overall screening rate among the more than 20,000 participants remained very low: under 20%.Meyerhardt points out that the UCLA researchers only looked at outreach efforts via a patient portal. Other strategies need to be explored, he says, the most important of which should be active engagement between a patient and their provider, who could play an essential role in discussing the benefits of screening and the available options.The findings also underscore the important role the US Preventive Services Task Force plays in Americans’ health. The panel of volunteer experts in primary care has significant influence over the practice of medicine and access to care in the US.Under the Affordable Care Act, any service the panel finds to have reasonable value must be covered by insurers without requiring a co-pay — a factor that can influence behaviour. For example, even though the American Cancer Society in 2018 suggested colon cancer screening begin at 45, screening rates didn’t markedly rise until the Preventive Services commendation in 2021.Yet Health and Human Services Secretary Robert F. Kennedy Jr. is said to be planning to dismiss the task force, a move that public health experts fear could set back preventive care across the country. The push to encourage more people to begin screening for colon cancer as soon as they are eligible faces additional obstacles. Although screening rates rose across all demographic groups by 2023, fewer than 14% of uninsured people in their mid-to-late 40s were up to date — a figure that’s not surprising given that a colonoscopy costs, on average, more than $2,400. Yet some 17 million Americans are expected to lose health insurance under President Donald Trump’s new tax law.Sensible policy changes have produced real gains in the fight against colon cancer. It’s a shame that shortsighted, harmful decisions threaten to undermine that progress..© 2025 Bloomberg L.P.

Why a rise in colon cancer diagnoses is a good thing: Lisa Jarvis

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