Lower Screening Age Prompts Need for Personalized Bowel Cancer Surveillance Strategies

Australia has recently lowered the recommended starting age for bowel (colorectal) cancer screening from 50 to 45 years old. This change aims to enable earlier detection and improve health outcomes but also raises concerns about the increased demand on an already strained healthcare system. Researchers from Flinders University warn that more younger adults will likely require ongoing surveillance, including regular colonoscopies, which are the gold standard for diagnosing bowel cancer. However, colonoscopies are invasive procedures that carry potential risks and require extensive preparation.

To address these challenges, the research team is exploring alternative screening approaches, such as fecal tests, to supplement traditional methods. Their recent study investigated the preferences of at-risk populations—both under and over 50 years—regarding surveillance options. Findings reveal a strong preference among most participants for more frequent screening than current guidelines recommend. Many also viewed fecal tests as a reassuring tool that could be used between colonoscopies, especially for those with heightened anxiety about bowel cancer.

Notably, younger adults exhibited higher levels of fear related to bowel cancer, influencing their desire for increased surveillance and comfort with non-invasive testing. The study suggests that integrating fecal tests into surveillance protocols could allow for personalized and more flexible screening schedules, potentially reducing the number of colonoscopies needed over a lifetime. This approach could help optimize healthcare resources, improve patient peace of mind, and adapt to the rising trend of early-onset bowel cancer, which currently accounts for about 11% of cases in Australia.

As early-onset bowel cancer continues to increase worldwide, updating surveillance guidelines to reflect patient preferences and psychological factors becomes increasingly important. Healthcare providers are encouraged to consider these findings to enhance screening strategies and improve outcomes for younger adults at risk.

Source: https://medicalxpress.com/news/2025-04-screening-age-tailored-bowel-cancer.html