With colon cancer on the rise under age 55, doctors work to boost screening

BRYN MAWR, Pennsylvania (WPVI) -- Several years ago, the starting age for colon cancer screening was lowered from 50 to 45, to address a rise in cancer among those under 55.

For those in line for their first test, it's time to check out the options.

For decades, Andrew O'Donnell has taken care of others, as a nurse and EMT.

At 48, he learned it was time to take action against colorectal cancer.

"I saw something on Main Line Health's website about how they were changing the age from 50 to 45," O'Donnell recalls.

Main Line Health Colorectal surgeon Phillip Pearson says cancer in Andrew's age group has doubled since 1995, and cases are more advanced.

"Do you have any family history of colon cancer or colon polyps?" asks Dr. Pearson during an appointment with Andrew.

Andrew doesn't, but Dr. Pearson says anyone who does, needs a colonoscopy before age 45.

Symptoms like bleeding, sudden weight loss, a change in bowel habits, and unexplained abdominal pain also call for a colonoscopy.

The test detects and removes polyps - tiny growths in the colon which may become cancerous.

Dr. Pearson says it does triple duty:

"Goes from screening to therapy, to prevention in 30 seconds. And that doesn't happen with any other screening tests," he notes. "The earlier you catch it, the more likely you are to live a nice, long, healthy life."

The use of at-home tests boomed during the pandemic when hospital procedures were limited.

Dr. Pearson says they are important.

"It does look for genetic evidence that a polyp or a cancer is living in your colon. And it also looks for evidence of blood in your colon," he says.

But one drawback is that there can be unrelated reasons for a little blood in the colon.

And if the test comes back positive, patients need a colonoscopy for follow-up.

Andrew says the colonoscopy prep was annoying, but not bad.

He enlisted his family.

"And my kids, every 15-20 minutes, were bringing me a new cup of Gatorade with Miralax in it," Andrew says.

He'll be screened again in five years because Dr. Pearson removed a benign polyp.

It's a 10-year interval if the test is clear.

But Andrew doesn't mind.

"It's simple. Shouldn't even be a question. So that way you can be there for your family," he says.

Virtual colonoscopies, which use a CT scan to look into the colon, are another option. Their cost is covered by Medicare, Medicare Advantage, and most commercial insurance providers.

Even though health insurance pays for colonoscopies, and Medicare and most insurance companies cover the Cologuard stool test, fewer than 40 percent of those under 55 get screened.