Lead Time and Tailored Messaging Promote Early-Onset Colorectal Cancer Prevention and Screening

The American Cancer Society predicts 158,850 new cases of colorectal cancer and 52,230 deaths in 2026. Rates have declined for both men and women since 2011, particularly among those over age 65. This decline is likely due to reduced smoking and increased uptake of screening. Unfortunately, there has been an increase among those younger than age 55 years since the mid-1990s, likely due to the lifestyle of those born after 1950. Early-onset colorectal cancer is defined as a diagnosis before the age of 50 years. Guidelines now recommend screening for average-risk patients begin at age 45 years (formerly 50 years). High-risk patients should start screening at age 40 years, and possibly earlier. Patients need to learn about this recent change. A high index of suspicion is helpful when any patient presents with complaints of unexplained weight loss, abdominal pain, bloating, change in bowel habits, or rectal bleeding. These patients should be referred, regardless of age, for a diagnostic colonoscopy. Primary care providers can improve their practice's screening rates using evidence-based strategies. The gastroenterology nurse is in a key position to implement lead-time messaging with tailored messages to promote on-time screening and primary prevention through diet and lifestyle.