The Startling Rise in Colon Cancer Among 45–49 year Olds

Should I book my colonoscopy?

I am 45 years old. And I have been 45 years old for eight months now. And I’m a doctor. A doctor who prides himself on being up to date on medical guidelines, practices and evidence. And you know what I have not done yet? Not even made an attempt to do yet? Scheduled my screening colonoscopy.

And let me be clear, this is not out of some high-minded concern for overdiagnosis or the issue of false positives in screening exams. This is pure, unadulterated, laziness. Or perhaps, if I’m being generous, I simply have too many other things going on in my life to take the twenty minutes to get this thing scheduled.

The thing is, I probably should, because the rate of colorectal cancer among people ages 45–49 has been going up steadily since at least the mid-90s, and dramatically over the last few years.

We’re going to dig into the rising incidence of so-called “early onset” colon cancer in a minute, but let me point out that, in recognition of the changing demographics of the disease, the United States Preventive Services Task Force (yes, that same USPSTF that may soon be fired en masse by RFK Jr.) changed their recommended starting screening age from 50 to 45 years of age in 2021.