Are more frequent colonoscopies the key to stifling the CRC climb?

In 2021, the official recommended age for screening colonoscopies was decreased from 50 to 45. But with colorectal cancers on the rise in younger populations, some gastroenterologists are asking if further recommendations to colonoscopy procedures are on the horizon. 

Christina Seo, MD, a colorectal surgeon at Holy Name Medical Center in Teaneck, N.J., said shortening the recommended interval could improve cancer outcomes. 

"We find that –– and it's mostly anecdotal –– patients coming up with cancers [and] that we wish we had done a shorter interval to save everybody a lot of headache," she told Becker's. "I'm much more comfortable with a five-year interval." 

Current medical recommendations suggest a colonoscopy every 10 years for individuals without any increased risk factors, such as a family history of cancerous polyps or other gastrointestinal diseases. Per Dr. Seo's suggestion, anyone older than 45 would receive a screening colonoscopy every five years with the hopes of catching cancers earlier and saving patients the financial and physical hardship of late-stage cancer. 

Carl Dettwiler, MD, a gastroenterologist at Gem State Endoscopy in Lewiston, Idaho, told Becker's a five-year interval would not necessarily address the delay in detecting CRC cases. 

"The concept is to prevent as much colon cancer as we can with the least amount of colonoscopies," he said. "I generally follow the recommendations regarding time intervals from the latest Multisociety Task Force. Depending on previous or current findings, the time interval could be one year, three years, five years, seven years or 10 years.

"Every five years is a waste of time and unnecessary colonoscopies for some — , and waiting too long for some." 

Increasing the recommended interval for colonoscopies would also likely be met with challenges from payers in an industry already struggling with declining reimbursement rates, Dr. Seo said. 

"[As a] standard practice, it's going to be hard to get insurances to agree to anything less than 10 years, because it's been established for so long. Anything less than that, anything less than that, you know they're just going to see the dollar signs," she said. "We do shorter intervals for any suspicious or any new symptoms. [If a] patient has bleeding or weight loss or anemia, things like that, and we're concerned that something has grown in the time between the last colonoscopy, then we definitely will push harder to do it sooner. But for somebody who's completely asymptomatic, it is hard to justify to the insurance companies." 

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