Why the Norwegian Directorate of Health Recommends Colorectal Cancer Screening Starting at 55

The American Cancer Society has updated the screening guidelines for colorectal cancer with recommendations that testing starts at the age of 45 – five years earlier than the current screening age guideline for screening at age 50. The recent screening age recommendation was updated due to the fact that more young people are diagnosed with colorectal cancer and the number is increasing. If screening is started at a lower age, more lives will be saved.

Colorectal cancer is a common cancer in Norway and its prevalence has increased in the past 50 years. Each year, over 4000 Norwegians are diagnosed with colorectal cancer and 1500 die from the disease.Two Norwegian doctors do not agree with the new guidelines from the American Cancer Society.

They argue that;

• Screening at 45 is too early and unnecessary since only a few young people are diagnosed with colorectal cancer. The increase of colorectal cancer incidence in young people in the United States is minimal and 99.9% of people under the age of 50 do not have colorectal cancer and therefore screening cannot save them.

• They also said that the new guidelines will be expensive and the young healthy people will be subjected to unnecessary screening procedures. They also pointed out that the increase in colorectal cancer in young people in the US may be due to increased screening procedures.

The US and Norway do not have the same system of screening for colorectal cancer meaning that the two countries aren’t comparable. In the US, it is the doctor or patient who takes the initiative to conduct or undergo the screening.

• The new programfor screening in Norway is scheduled to start screening at age 55 in 2019. During this time, all the 55-year old individuals will be invited to participate in the national colorectal cancer screening program.

The Norwegian Directorate of Health operated a pilot program to form the basis for these recommendations. It was decided to start screening at 55 because it was the age at which the effect of lowering the occurrence of and mortality rates from colorectal cancer would be greater. At the same time, it would limit the risks and disadvantages. The health authorities in Norway expect high participation in the screening program at this age. Also, the appearance of polyps largely increases from the age of 55.