Dr. Mark Schattner, Chief of Gastroenterology at MSK
To mark National Colorectal Awareness Month this March, Memorial Sloan Kettering Cancer Center (MSK) today stressed the importance of resuming vital screenings for colorectal cancer. The American Cancer Society (ACS) has recommended colorectal cancer screenings begin at age 45 and the U.S. Preventive Services Task Force (USPSTF) has issued a draft recommendation to lower the screening age to 45 from 50 due to the rise in early onset colorectal cancer. When finalized, the new recommendations will mean insurance companies will begin to cover screenings at age 45.
This rise in young onset colorectal cancer comes as many Americans have delayed cancer screenings and other necessary cancer treatment and care during the COVID-19 pandemic. Studies conducted at the initial peak of the pandemic show that colon cancer screenings fell by nearly 75 percent. Recent research published in the medical journal JAMA Network Open found that patients delaying care for just a few months may result in a much higher death rate for several common cancers, including colorectal cancer.
“It’s imperative that patients resume regular cancer screenings. Colorectal cancer is the third leading cause of cancer death in the United States, but when people are screened and their cancer is diagnosed early, the chances of survival are extremely high,” said Mark A. Schattner, MD, MSK’s Chief of Gastroenterology. “Screening is particularly important because people diagnosed with colorectal cancer typically do not display symptoms until the cancer has progressed. Screenings save lives, and we urge people to resume their routine screenings.”
Researchers at MSK are also exploring new therapies and diagnostic tools for colorectal cancer patients through clinical trials. MSK’s Hereditary Colorectal Cancer Family Registry seeks to understand the genetic causes of colorectal cancer and new ways to prevent, diagnose, and treat it. Those on the registry can learn more about their own risk and keep up to date on new research that may affect them.
While these advances are promising, colonoscopies remain the “gold standard” because they can both detect and remove cancerous polyps. For those who cannot undergo a colonoscopy, stool-based testing, easily done at home, improves the prognosis for people with colorectal cancer by detecting early-stage disease that is usually very treatable.
Care Disparities
The tragic death of 43-year-old actor Chadwick Boseman in 2020 from colon cancer brought attention to the disproportionate impact of colorectal cancer on underserved communities.
“Data shows that Black men and women have higher incidences as well as higher mortality rates for colorectal cancer,” said Carol Brown, MD, Chief Health Equity Officer at MSK. “More research needs to be done on whether this disparity is related to biological determinants or lack of access to care. What we do know is that routine screenings, which lead to early detection of colorectal cancer, increase survival. Therefore, we recommend that the public, especially those in underserved communities, speak with their physician about colorectal screenings and care.”
MSK’s colorectal cancer team has been working to amplify the importance of screening to unrepresented communities. As advisors to the New York City Citywide Colon Cancer Control Coalition (C5), MSK helps the coalition increase the rate of colorectal cancer screening among citizens of New York City, especially members of racial and ethnic minorities.
Rise in Young Onset Colorectal Cancer—MSK leads the way with the first ever Center for Young Onset Colorectal Cancer
Incidence of young-onset colorectal cancer has become more common in people under 50 since the 1990s. To focus research on this trend and build upon efforts to improve prevention, diagnosis, treatment, and outcomes for patients, MSK created the Center for Young Onset Colorectal Cancer, the first clinic of its kind in the world.
“The Center for Young Onset Colorectal Cancer is the first clinic dedicated to determining what’s driving the rising rate of colorectal cancer in younger people. If a person has persistent gastrointestinal symptoms, a family history of colorectal cancer, or a hereditary predisposition to the disease, they should speak with their physician right away as they may need to undergo regular colonoscopies starting at a younger age,” shared Andrea Cercek, MD, co-director of the center. “At MSK, we also understand that being diagnosed with cancer at a young age can be frightening. That’s why we help patients cope with the unique challenges they face and create an individualized treatment plan that addresses these challenges, including incontinence, diminished sexual function, changes in body image, and other psychosocial issues.”
“MSK will continue finding innovative ways to detect and treat this deadly disease, as well as addressing barriers to ensure all men and women who are of screening age, or those who have a family history of colorectal cancer, are able to receive life-saving screenings,” Dr. Schattner said. “We must continue to raise awareness, jumpstart screenings and take action in the hope of diagnosing younger patients and those in underserved communities at earlier and more curable stages.”
