Well, we did a study at Scripps and looked at our last 2,000 or so patients with colon cancer, and we looked at the ages. Ten percent were less than 50, and that sort of matches the national average. We tried to look at why. Were they heavier? Were they smokers? Did they have family histories? Nothing came out that separated them out. So, it’s very frustrating. We think something in the environment has made them more prone to get this, but we can’t figure out what it is right now.
Having said that, the American Cancer Society did a modeling exercise saying, if we move screening down, could we save lives in those 10 percent? What’s concerning is that mortality has gone up in people under 50 for colon cancer 11 percent in the last 10 years, and that’s what they’re trying to stop. But it’s a problem because you do a lot of extra colonoscopies in people that wouldn’t need it. We’ve tried to decide what to do. They didn’t put any restrictions on what kind of screening. They said, "Just consider screening [at age] 45." It’s a qualified recommendation, not mandatory.
What I recommend now is that patients age 45 get the stool test, the FIT test. You can mail it in. If that’s negative, you can feel good. Get that every year, and then I think the regular guidelines would say FIT test or colonoscopy at age 50 would happen. Of course, if you have any symptoms, you immediately should get a colonoscopy if you’re 45 or older.
It’s fine to go to your primary care doctor. They’re very good at sorting out, "Oh, I think this is just a hemorrhoid. Oh, I think we should definitely do a flexible sigmoidoscopy or a colonoscopy."
There was a big push by all the societies to get 80 percent of people eligible screened by this year. But the problem is people still avoid it.
I get the idea, "I don’t have time to do a colonoscopy, I don’t have that." In that case, just give me a stool sample. If that’s negative, we're good to go. But the other side of that coin is if it’s positive, you really need a colonoscopy, because that means you could have colon cancer.