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Updated: Jul 4, 2026
06:28
E-Patient Counseling Trial (E-PACO): Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
Lead Time and Tailored Messaging Promote Early-Onset Colorectal Cancer Prevention and Screening.
Linda Morrow1, Beverly Greenwald2
1About the authors: Linda Morrow, DNP, MSN, MBA, NEA-BC, CPHQ, CNOR, RN, is a Clinical Professor of Nursing, Dr. Susan L. Davis & Richard J. Henley College of Nursing, Sacred Heart University, Fairfield, Connecticut, USA.
Summary
Colorectal cancer screening guidelines have changed, recommending earlier detection for average-risk individuals starting at 45. Increased early-onset colorectal cancer necessitates a high index of suspicion for all patients presenting with relevant symptoms.
Area of Science:
- Oncology
- Public Health
- Gastroenterology
Background:
- Colorectal cancer (CRC) incidence is projected to reach 158,850 cases and 52,230 deaths in 2026.
- While CRC rates have declined in older adults due to reduced smoking and increased screening, there's a concerning rise in early-onset CRC (diagnosed before age 50) among those younger than 55, linked to lifestyle factors.
Purpose of the Study:
- To inform healthcare providers and patients about updated colorectal cancer screening guidelines.
- To emphasize the importance of early detection and a high index of suspicion for colorectal cancer, especially in younger populations.
- To highlight strategies for improving screening rates in primary care and the role of gastroenterology nurses in patient education and prevention.
Main Methods:
- Review of current epidemiological trends in colorectal cancer incidence.
- Analysis of updated screening recommendations from major health organizations.
- Discussion of clinical presentation and diagnostic approaches for colorectal cancer.
- Exploration of evidence-based strategies for enhancing screening uptake and primary prevention.
Main Results:
- Screening for average-risk individuals is now recommended to begin at age 45 (previously 50).
- High-risk individuals should initiate screening at age 40 or earlier.
- A high index of suspicion is crucial for patients presenting with symptoms such as unexplained weight loss, abdominal pain, bloating, altered bowel habits, or rectal bleeding, irrespective of age.
Conclusions:
- Updated screening guidelines necessitate increased awareness and implementation by healthcare providers.
- Early-onset colorectal cancer requires vigilance, with prompt referral for diagnostic colonoscopy for symptomatic patients.
- Primary care providers and gastroenterology nurses play vital roles in promoting timely screening and lifestyle-based prevention strategies to combat colorectal cancer.
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