Data: Colorectal cancer more aggressive in younger people; doctors urge early screenings

Health

PROVIDENCE, R.I. (WPRI) ─ Doctors say there is a growing concern about rising rates in the country’s third leading cause of cancer-related deaths in both men and women.

Earlier this week, the U.S. Preventative Services Task Force issued draft recommendations, which propose adults of “average risk” for colorectal cancer be screened from ages 45 to 75. Previously, the task force recommended screenings to begin at age 50.

The task force proposal brings it in line with guidelines from the American Cancer Society, which in 2018 lowered the screening age from 50 to 45.

The draft recommendations note recent epidemiological data suggests “colorectal cancer incidence in 45-year-old adults now approaches that of persons age 50 years in the era prior to the introduction of routine screening.”

Dr. Fadlallah Habr, director of the Gastroenterology Division at Lifespan, says in younger people, the disease tends to be more aggressive, with a higher mortality rate. He adds right now, it’s not immediately clear why that is.

“Whether this is genetic predisposition of those individuals or environmental, it’s really hard to tell at this point,” Habr said.

Habr also noted the steepest increase in the rate of detection has been with people aged 40 to 54, but says the risk in those over the age of 65 has been on the decline, largely due to more screenings.

“If you think about it, this cancer is preventable. You do a colonoscopy, for example, you remove a polyp, you know, that’s it,” Habr said.

The draft recommendations come almost two years after Rhode Island Sen. Maryellen Goodwin introduced a bill that would make it mandatory for health insurance providers to cover colorectal cancer screenings.

The bill would prohibit cost-sharing for patients 45 or older for colorectal screening examinations, laboratory tests and colonoscopies covered by health insurance policies or plans.

Goodwin, 56, was diagnosed with colorectal cancer last July, almost two years after she became the lead sponsor on the bill.

“It was just very ironic,” Goodwin told 12 News in a virtual interview Wednesday.

“The American Cancer Society just gave me this bill and said, ‘Senator, would you be willing to sponsor it?’ I looked it over, thought it was a good idea,” Goodwin said.

The state senator says when she went for a colonoscopy in 2019, doctors initially told her not to be nervous.

“They were like, ‘Don’t be nervous Maryellen. People are much, much older than you and they’re screening for the first time in their sixties and seventies,’ and I was in my early 50s,” Goodwin recalled. “So I didn’t expect to have such news, that I myself was suffering from colorectal cancer.”

In August, the world learned “Black Panther” star Chadwick Boseman died after a largely secret battle with colon cancer. All the more shocking, Boseman was 43 years-old.

“Any age, anybody, any economic circumstances they may have. It doesn’t discriminate, I’ll tell you that. So, early detection is just the best way to treat it,” Goodwin said.

Goodwin says she was pleased to learn of the task force draft recommendations, but says she would plan to refile her bill next session even if the recommendations are finalized before that.

The bill previously passed in the Senate, and was later referred to the House Committee on Health, Education and Welfare.

“My goal is not really about age as much as about the cost sharing and eliminating the cost to Rhode Islanders,” Goodwin said.

“We’ve done it in the past, recently, for the breast cancer screening, and so now the American Cancer Society here in Rhode Island wants us to do the same for the colon screening,” she continued.

Goodwin has been receiving chemotherapy for the last 15 months, and says she received her 32nd round this week. She was undergoing a 48-hour home treatment during her virtual interview with 12 News.

“I’m getting fantastic care, I want to add. I’m being treated at the Miriam Cancer Center, I have a fabulous, bright, smart, competent oncologist. I’m in great hands,” Goodwin said. “There are treatments available. They’re not always easy, but they’re lifesaving. I look forward to a good outcome, eventually. It’s been a long road, so to speak, but I’m hopeful.”

If the task force recommendations are finalized, screenings for younger people would be covered by most private insurance plans, with no copay. The Affordable Care Act mandates that insurers cover services recommended by the task force.

The proposal is open for public comment through Nov. 23.

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