Do Men Need Colon Cancer Screening Earlier Than Women Do?

TUESDAY Sept. 27, 2011 -- Men may need to begin colon cancer screening earlier than women, new research suggests.

The study found that men were far more likely to have potentially precancerous lesions (also called polyps or adenomas) in their colon -- 24.9 percent of men compared to 14.8 percent of women -- and to have them at an earlier age.

"In our study, analysis of age- and sex-specific prevalence of adenomas, advanced adenomas and colorectal cancers indicates a significantly higher rate of these lesions among men compared with women in all age groups, suggesting that male sex constitutes an independent risk factor for colorectal carcinoma and their precursor lesions, and indicating new sex-specific age recommendations for screening colonoscopy," said study author Dr. Monika Ferlitsch, an associate professor of medicine at the Medical University of Vienna in Austria.

But, at least one U.S. expert says that screening guidelines don't need to be changed based on these findings alone.

"This is a very interesting, very well-done study that included a lot of people. But, I have a lot of concerns about making changes to currently accepted screening guidelines that are well thought-out," said Dr. David Bernstein, chief of the division of gastroenterology at North Shore University Hospital in Manhasset, N.Y.

"There were very few people under 50 in this study, and all of those were referred because they have a high risk of colon cancer," noted Bernstein, who said all of these people would have been referred for screening in the United States because of their higher risk anyway. He added that while the issue might warrant further investigation, he doesn't see any need to make gender-based screening recommendations for colorectal cancer.

Results of the study are published in the Sept. 28 issue of the Journal of the American Medical Association.

Current colorectal cancer screening guidelines recommend that both men and women begin colonoscopy screening at age 50, according to background information in the study. People who have a higher risk of developing colorectal cancer are advised to begin screening earlier. How early depends on their particular risk factors, said Bernstein.

Ferlitsch and her colleagues began the study because other research had shown that men were at greater risk of having advanced colorectal cancers than women, and they wondered if earlier screening might catch some of these cancers at an earlier, more treatable -- or even preventable -- stage.

Their study included 44,350 Austrians who participated in a national colonoscopy screening program. The average age of the study participants was 60.7 years for men and 60.6 years for women. Just over 1,600 of the study participants were under 50, according to the study.

Overall, the researchers found polyps in 34.4 percent of those screened. They also found colon cancer in 0.4 percent and rectal cancer in 0.2 percent. When polyps are found in a colonoscopy, they can be removed before they have a chance to develop into cancer. Most polyps are adenomas, which are considered precancerous.

Nearly one-quarter of men had polyps compared to 14.8 percent of the women. Almost 19 percent of men between the ages of 50 and 54 had polyps. In women of the same age, just 11 percent had polyps. However, a similar number of older women -- those between 65 and 69 years -- had about the same rate of polyps as the younger men, the study found.

"It is worth it to get screening colonoscopy early enough -- if you are 50 years old if you are a woman, and if it's possible, if you are 45 years old if you are a man -- since 35 percent of healthy, asymptomatic individuals have polyps and 20 percent of all those have adenomas, which are really easy to remove before they develop into colorectal cancer," said Ferlitsch.

"Colorectal cancer is a silent disease. But, we can find it early and prevent it with adequate screening," said Bernstein.

More information

Learn more about colon cancer screening from the U.S. Centers for Disease Control and Prevention.

Posted: September 2011


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