MSGID: 1:317/3 6274a4e8   
   PID: hpt/lnx 1.9.0-cur 2019-01-08   
   TID: hpt/lnx 1.9.0-cur 2019-01-08   
    Starting screening before age 50 is found to significantly reduce the   
   risk and incidence of colorectal cancer in women    
      
     Date:   
         May 5, 2022   
     Source:   
         Massachusetts General Hospital   
     Summary:   
         A new study reports a 50 to 60 percent lower risk of colorectal   
         cancer (CRC) among women who started endoscopy screening at age   
         45 compared to those who had not undergone screening at all.   
      
      
      
   FULL STORY   
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   Screening for colorectal cancer (CRC) in women before the age of 50   
   can significantly reduce the risk of CRC compared to those who have no   
   endoscopic screening or decide to initiate testing at age 50, according   
   to a new study from Massachusetts General Hospital (MGH). These findings,   
   published in JAMA Oncology, support recommendations from the American   
   Cancer Society and the US Preventive Services Task Force over the past   
   four years to commence screening at age 45 to address the steady increase   
   in cases of younger-onset CRC.   
      
      
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   "While there's been an alarming increase in the incidence of colorectal   
   cancer in recent decades in younger individuals, screening has   
   largely been focused on people over 50," says Andrew Chan, MD, MPH,   
   a gastroenterologist and epidemiologist at MGH, and senior author   
   of the study. "Our work provides first-of-its-kind data to show that   
   initiating screening at a younger age can reduce an individual's risk   
   of colorectal cancer and the population's overall incidence of cancer,   
   thus demonstrating the substantial impact of earlier screening on both   
   individual and population-wide scales."  Among all cancers, colorectal   
   has the third highest incidence of death in both men and women in the   
   U.S. Even as the overall number of CRC cases has declined, the incidence   
   among people younger than 50 -- a group for whom routine screening   
   was not recommended until only recently -- increased by 51 percent   
   from 1974 to 2013, according to epidemiological data. To evaluate the   
   association between CRC risk and endoscopies initiated at different ages,   
   MGH conducted a comprehensive study that included 111,801 women from the   
   Nurses' Health Study II, a large cohort of registered nurses residing   
   in 14 states.   
      
   Researchers found a 50 to 60 percent lower risk of CRC among women who   
   started endoscopy screening at age 45 compared to those who had not   
   undergone screening at all. In addition, they learned that starting   
   screening at ages 45 to 49 resulted in a significant reduction in the   
   population's actual cases of CRC diagnosed through age 60, compared   
   to a strategy in which women began screening at ages 50 to 54. While   
   the study was focused on women, Chan suggests the same benefits likely   
   accrue to men, though he adds further studies are needed.   
      
   The traditional CRC screening tool is the colonoscopy, where a physician   
   uses a flexible tube with a camera to examine the colon and rectum. This   
   invasive technique allows for removal of polyps that could over time   
   become malignant, and for detection of early-stage cancers that can be   
   treated more effectively.   
      
   Options for screening have expanded more recently through stool-based   
   tests that are non-invasive and may be more convenient for individuals.   
      
   Chan points to the substantial public health implications of his team's   
   research. "Any trepidation that clinicians might have had about the   
   effectiveness of CRC screening at a younger age will hopefully be allayed   
   by these results," he says. "Our data show that we have an effective   
   tool to address the epidemic of colorectal cancer among younger adults,   
   and hopefully this will encourage physicians to have a conversation about   
   screening with their younger patients which, in turn, will motivate them   
   to follow through and get screened."  Chan is chief of the Clinical and   
   Translational Epidemiological Unit at MGH, and director of Epidemiology,   
   Mass General Cancer Center, and the Daniel K.   
      
   Podolsky Professor of Medicine. Lead author Wenjie Ma, ScD is an   
   instructor in Medicine, and co-senior author Mingyang Song, MD, is   
   assistant professor of Medicine, both in the Clinical and Translational   
   Epidemiology Unit at MGH.   
      
   The study was funded by the National Cancer Institute and National   
   Institutes of Health.   
      
      
   ==========================================================================   
   Story Source: Materials provided by Massachusetts_General_Hospital. Note:   
   Content may be edited for style and length.   
      
      
   ==========================================================================   
   Journal Reference:   
      1. Wenjie Ma, Molin Wang, Kai Wang, Yin Cao, Ellen Hertzmark,   
      Shuji Ogino,   
         Kimmie Ng, Walter C. Willett, Edward L. Giovannucci, Mingyang   
         Song, Andrew T. Chan. Age at Initiation of Lower Gastrointestinal   
         Endoscopy and Colorectal Cancer Risk Among US Women. JAMA Oncology,   
         2022; DOI: 10.1001/ jamaoncol.2022.0883   
   ==========================================================================   
      
   Link to news story:   
   https://www.sciencedaily.com/releases/2022/05/220505143805.htm   
      
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