As Colorectal Cancer Incidence Increases in Younger Patients, USPSTF Issues New Screening Guidelines. Here’s How Nurses Can Encourage Uptake

March 19, 2024 by Anne Richter MSN, RN, AGCNS-BC, OCN®

In 2019, 20% of colorectal cancer diagnoses (https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/colorectal-cancer-facts-and-figures/colorectal-cancer-facts-and-figures-2023.pdf) occurred in patients younger than 55—approximately double the diagnosis rate in 1995. Since 2010, rates of advanced disease have increased about 3% annually in people younger than 50. 

Researchers are actively investigating the reasons behind that trend. Some of the contributors may include an increase in obesity rates and sedentary lifestyles, diets high in meats and processed foods, genetic factors (e.g., Lynch syndrome (https://voice.ons.org/news-and-views/genetic-disorder-reference-sheet-lynch-syndrome-hereditary-nonpolyposis-colorectal), familial adenomatous polyposis (https://voice.ons.org/news-and-views/genetic-disorder-reference-sheet-familial-adenomatous-polyposis)), family history of polyps or colorectal cancer, environmental exposures to certain pollutants and toxins, delayed diagnosis because of nonspecific symptoms, and lack of general awareness and access to healthcare providers.

Screening Adherence Saves Lives

In response to those latest statistics, the U.S. Preventive Services Task Force (USPSTF) modified its guidelines to begin screening five years earlier than previously recommended. Now, regular screening should begin at age 45 (instead of age 50), with screening every 10 years for those at average risk. For patients at increased risk (https://www.cdc.gov/cancer/colorectal/basic_info/risk_factors.htm#:~:text=Lack%20of%20regular%20physical%20activity,Overweight%20and%20obesity.), providers may recommend beginning screening earlier than age 45 or recommend screenings more frequently than every 10 years.

Currently, only 69% of eligible people in the United States are up to date on their colorectal cancer screening tests. Using computer modeling, researchers examined (https://www.cancer.gov/news-events/cancer-currents-blog/2024/more-cancer-screening-modeling-study-knudsen) the impact of a 10% uptake in screening rates. The results suggest that such an increase could prevent an additional 21% of colorectal cancer–related deaths—translating to 11,070 lives saved. These results support that regular and timely screening is necessary for early detection, intervention, and, ultimately, ending cancer as we know it (https://www.whitehouse.gov/cancermoonshot/).

National Campaign Spreads the Message

To encourage individuals to get screened regularly for colorectal cancer, the Centers for Disease Control and Prevention developed the Screen for Life: National Colorectal Cancer Action Campaign (https://www.cdc.gov/cancer/colorectal/sfl/index.htm#:~:text=CDC%27s%20Screen%20for%20Life%3A%20National,before%20they%20turn%20into%20cancer). Through public service announcements in television, radio, print media, and digital advertising primarily targeted to those aged 45 or older, the initiative is raising awareness about the importance of colorectal cancer screening.

The Screen for Life print and media resources (https://www.cdc.gov/cancer/colorectal/resources/index.htm) represent many cultures, both for inclusivity and to acknowledge the populations that traditionally have lower screening rates. So far, the messages have garnered more than $300 million in donated ad value and 21 billion impressions (the number of times the messages have been seen or heard).

Use Your Nursing Voice to Transform Colorectal Cancer Trends

Oncology nurses are in a prime position to promote early and regular screenings. Here are some ways oncology nurses can make an impact:

By educating our patients, especially younger individuals, on the importance of prevention and early detection through screenings; addressing screening barriers, such as lack of awareness, cultural considerations, or socioeconomic factors; and partnering with our healthcare team colleagues and community on solutions, nurses can ensure that our patients obtain timely screenings and appropriate follow-up care. We can also feel good knowing that we are able to support and empower our patients to make informed decisions about their health care.


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