Rising rates of bowel cancer in Australians under 50 have prompted a long-awaited reduction in the recommended age to begin screening according to Bowel Cancer Australia, with the newly updated clinical practice guidelines recently endorsed by the National Health and Medical Research Council (NHMRC).
With 1-in-9 new bowel cancer cases (1,716) occurring in this cohort, population screening for people with average risk of developing bowel cancer will now be recommended every two years for people aged 45-74, down from 50-74, along with a lowering of the National Bowel Cancer Screening Program (NBCSP) start age from 50 to 45.
People aged 40-44 (previously 45-49) can now also request bowel cancer screening via their healthcare professional prior to receiving their first NBCSP invitation.
Bowel Cancer Australia CEO, Mr Julien Wiggins said that Australians aged 40-49 now accounted for 56% of new cases and 64% of deaths of those diagnosed under age 50, and the milestone updates to the guidelines was the result of an intense five-year campaign for change.
“It has been years of tireless advocacy, and we remain grateful to our passionate team of advocates for their support,” he said.
“However, work remains, and we are now calling on the Federal Government to approve, fund and implement a lower NBCSP screening start age to stop people dying from early-onset bowel cancer.
“Youthfulness should not be a barrier to timely diagnosis, so it is equally imperative the updated guidance for people aged 40-44 is implemented by healthcare professionals.”
Recommendations to begin screening from age 45 were first introduced in the US in 2018, when the American Cancer Society (ACS) also updated their guidelines in response to rising rates of bowel cancer incidence and mortality in young and middle-aged populations.
By 2021, 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), had all joined the ACS in updating their guidelines to recommend screening from age 45 rather than 50.
However, while the changes have been welcomed by experts, Bowel Cancer Australia’s Medical Director, Associate Professor Graham Newstead AM, explained that while lowering the screening age was one step forward for people aged 40 and over, it did not address the rise in early-onset bowel cancer.
“We still don’t know why younger people are getting bowel cancer,” Associate Professor Newstead said.
“What we do know, is that people under the age of 50 have an increased risk of developing bowel cancer when they experience one or more symptoms of abdominal pain, rectal bleeding, diarrhoea, and iron deficiency anaemia between three months and two years prior to diagnosis.
“Younger people need to be aware of, and act on, these potential signs and symptoms and have them investigated to rule out bowel cancer as an underlying cause.”
Recent Australian research has shown that self-advocating is the only consistent and reliable resource for overcoming age bias, barriers to diagnosis, and optimising outcomes for a disease that is not only on the rise, but the deadliest cancer for those aged 25-44.