In the coming days we’ll have a good opportunity to have a public discussion of our current colon cancer screening recommendations & when they should start (these talks have already been occurring in GI circles for years)

Here’s what I would ask you to remember during that time

1) there’s multiple methods of screening, not limited to but including high-sensitivity stool tests designed to detect blood in stool, a DNA stool test (Cologuard), colonoscopies and at this point less usefully, virtual colonography.

2) Rates of colon cancer in younger people have gone up but it still represents an absolute risk of just 1.3 more people per 100,000. The chances are still low, just higher than they were. Why is still a subject of investigation. This doesn’t make it less difficult of course.

3) Earlier screening is already (or should be) be taking place in people with predisposing syndromes like Lynch or people with a known family history of colon cancer or IBD.

4) the infrastructure to screen Americans under the current recommendations is already a daunting challenge and we’ll need to creative solutions if the guidelines change to include younger patients.

5) and yes, the guidelines will likely change. They have been changing and will probably continue to do so with newer information. Screening might start earlier and the time between screenings might change as well.

6) certain tests have risks that need to be considered. Colonoscopy is considered the gold standard for colon cancer screening and is a relatively safe procedure but all procedures have risk (sedation, infection peroration, etc)