Health Innovations

Colorectal Cancer: New Screening Guidelines and Treatments

Mar. 29, 2022

Rises in colorectal cancer in younger people have resulted in a new screening age recommendation from 50 to 45.

Colorectal Cancer: What is it?

Colorectal cancer is a cancer that starts in either your colon or your rectum—parts of your large intestine that make up the lower digestive tract.

According to the American Cancer Society, excluding skin cancers, colorectal cancer is the third most common cancer diagnosed in both men and women in the U.S. Unfortunately, there’s not a definite way to prevent colorectal cancer, however, it is possible to lower your risk by maintaining a healthy lifestyle. Here are a few tips:

  • Exercise regularly.
  • Eat lots of fruits, vegetables and whole grains.
  • Limit red and processed meats.
  • Maintain a healthy weight.
  • Avoid smoking or abusing alcohol.
  • Talk to your provider about when to get screened—colorectal cancer almost always develops from precancerous polyps (abnormal growths) in the colon or rectum. Screening tests can find precancerous polyps, so they can be removed before they turn into cancer. Screening tests can also find colorectal cancer early—when treatment works best. Examples of screening methods include a visual exam, such as a colonoscopy, or a stool-based test. 

The Current State of Colorectal Cancer 

Although colorectal cancer is one of the most common cancers in the U.S., cases in older patients have decreased since the mid-1980s, mainly thanks to screening and early detection. So, when should you get screened? As of early 2022, the American Cancer Society updated its recommendation for the colonoscopy screening age to be lowered from 50 to 45.

“Unfortunately, we are seeing an increase in colorectal cancer in younger people,” says Ian Paquette, MD, colorectal surgeon at the University of Cincinnati Cancer Center and Chief of the Division of colon and rectal surgery at the UC College of Medicine. “This has led to a change in the screening guidelines to receive a screening colonoscopy.”

This new screening age recommendation applies to every person in the United States, yet the rise in cases seems to be specific to certain regions.

“There are certain pockets where we’re seeing above-average increases, which includes Southern Ohio and Kentucky,” Jordan Kharofa, MD, radiation oncologist at the University of Cincinnati Cancer Center and associate professor in the department of radiation oncology at the UC College of Medicine, notes.

Researchers around the world are trying to figure out why younger people are developing colorectal cancer—including Dr. Kharofa and his team at the University of Cincinnati Cancer Center. As of now, Dr. Kharofa believes dietary issues could be the culprit.

“The individual patients are not necessarily overweight, but these portions of the country are known for having a high-sulfur microbial diet, which means low in fruits and vegetables, and high in saturated fats, processed meats and low-calorie drinks,” Dr. Kharofa says.

If you’re younger than the eligible screening age of 45, it’s still important to know and be on the lookout for symptoms. Abnormalities like blood in your stool or difficulties with bowel movements may mean you should talk to your provider about getting screened.

Newest Innovations in the Treatment of Colorectal Cancer

As the region’s only adult academic health program, the University of Cincinnati Cancer Center is motivated to improving treatments through participating in local and national clinical trial efforts. One of the latest scientific developments is a new approach to treating rectal cancer, with the goal of moving away from surgery, if possible.

“The problem with rectal cancer is specifically is where it is,” Earl Thompson, MD, surgeon at the University of Cincinnati Cancer Center, describes. “Removing the portion of the bowel that contains the tumor can lead to some lifelong consequences. The hope is that we can preserve normal sphincter functions so patients can go to the bathroom like they always have.”

Attempting to avoid surgery, doctors give patients radiation first, then a full dose of chemotherapy—providing them with an approximately 20% chance of complete disappearance of the tumor, avoiding surgery. Dr. Thompson notes that some patients who don’t respond as successfully to this regimen as others still may benefit from trying.

“Some patients have tumors that reduce in size, allowing surgeons to keep their colon or rectum intact, meaning no ostomy bag, which is a prosthetic medical device that collects waste,” Dr. Thompson says. “Other patients may not be as strong enough after the surgery to go through the additional round of chemotherapy, so this new approach knocks it out of the way first.”

The Academic Health Advantage: The University of Cincinnati Cancer Center Approach to Colorectal Cancer Treatment

With a long history of treating both the simple and very complex cases of colorectal cancer, the University of Cincinnati Cancer Center takes a team approach to developing a personalized treatment plan for each patient. This multidisciplinary collaboration includes surgeons, radiation oncologists, medical oncologists and gastrointestinal cancer experts in radiology and pathology.

“We all meet once a week in our gastrointestinal cancer tumor board to review the optimal treatment paths for the patient,” Dr. Kharofa explains. “This includes reviewing all aspects of their therapy, such as nonoperative management and potential clinical trials that the patient could be eligible for.”

Being diagnosed with colorectal cancer is scary—the University of Cincinnati Cancer Center works hard to lead the way in research, developing individualized treatment plans to ultimately spread hope to our patients and community.

The Gastrointestinal Cancer Center at the University of Cincinnati Cancer Center

Our experts subspecialize in gastrointestinal tract cancers, including the stomach, pancreas, liver, large and small intestine, spleen, colon, anus/rectum, gallbladder and peritoneal cavity. We focus the expertise of the region’s most advanced gastrointestinal cancer team on improving your odds of overcoming these cancers. Our nationally recognized cancer subspecialists offer you access to standard therapies, as well as the latest treatments and leading-edge clinical trials.

For more information, call 513-585-UCCC (8222).