Dr. Acuna-Villaorduna on the Increase of Early-Onset CRC Diagnoses

Ana Acuna-Villaorduna, MD, Heme/Oncology fellow at Montefiore Medical Center/Albert Einstein College of Medicine, discusses the increase of early-onset colorectal cancer (CRC), specifically in African-American and Hispanic populations.

Although incidence and mortality rates of CRC are decreasing, the incidence of patients diagnosed before age 50 are increasing. Early-onset CRC was encountered in 10.2% of the total population and the mean age at diagnosis was 42.7 years. The rate of left-sided tumors and stage III/IV at diagnosis is higher in early-onset CRC among all ages. Of people diagnosed with early-onset CRC at ages 45 to 49, African-Americans had a 50% higher mortality risk compared with non-Hispanic whites.

Several American cancer organizations are recommending different ages to begin screening for CRC, ranging from ages 45 to 50, according to Acuna-Villaorduna. Some societies are taking race and ethnicity into consideration when providing screening recommendations. For example, the American Society of Gastroenterology recommends that African Americans start screening at the age of 45. Meanwhile, the American Cancer Society recommends that colonoscopy screenings should begin at age 45 no matter what race or ethnicity.

Acuna-Villaorduna’s study concludes that CRC screening should start at age 45, in all minorities. Additionally, since early-onset CRC is mostly left-sided, at least flexible sigmoidoscopy should be considered for patients between 45 and 49 years.