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Many colorectal cancers can be prevented with adequate screening using colonoscopy or other screening techniques. Recently there has been an increase in early age-onset colorectal cancer (CRC), which has prompted some groups to recommend a reduction in the screening age to 45 years for average-risk individuals.

The aim of this prospective cohort study, published in , was to determine the proportion of early age-onset CRC cases that could have been diagnosed at an earlier stage or potentially prevented if high-risk screening guidelines had been followed and average-risk screening guidelines were changed to begin at age 45. The cohort included over 700 participants with early age-onset CRC, of which 14% had a family history, 12% had at least one heritable cancer syndrome, and 79% were sporadic. If those with a family history in a first-degree relative of any age followed high-risk screening guidelines, then 83% of patients would have been diagnosed earlier and 67% of patients may have been prevented from developing CRC. Similarly, for the sporadic cancers, if average-risk screening guidelines were implemented at age 45, then 41% of patients would have been diagnosed earlier.

This study is important because it shows the clinical impact of following CRC screening recommendations. While it is often not known if an individual has a heritable cancer syndrome prior to the diagnosis of CRC, family history is easily attainable. The study authors stressed the importance of adherence to guidelines for preventing CRC.

Michelle Long, MD, is an assistant professor of medicine in the department of medicine, section of gastroenterology, at Boston University School of Medicine in Boston, Massachusetts.

You can read an interview with the lead study author here, and the abstract of the study here.