USPTF Recommends Colon Cancer Screening for 45-year-olds

What’s New The U.S. Preventive Services Task Force (USPTF) recommends that adults with average risk start colon cancer screening at age 45 instead of waiting until 50. Additionally, new data suggests that certain adults between the ages of 76 and 85 years might also benefit, although to a lesser extent. The new guidelines were published in the May 18 issue of The Journal of the American Medical Association. Research Details The newly revised recommendations were developed after data showed that the benefits of lowering the screening age from 50 to 45 years, in terms of life years gained, in adults with average risk outweighed the small risks (bleeding, perforations) of colonoscopy procedures. Average risk is defined as no prior colon cancer diagnosis or family history of known genetic disorders that may predispose a person to colon cancer. Why This Matters Colon cancer is the third most common cause of cancer in the United States and the second leading cause of cancer death in the United States among men and women combined. Fortunately, it is also one of the most preventable due to the availability of screening tests that can detect precursors of the disease, in the form of polyps, and early disease, before it progresses. The best strategy is to speak to your practitioner to determine timing and type of screening test based on your personal and family history, age, and overall risk factors. RELATED: Cancer Trends: How Has the COVID-19 Pandemic Affected Cancer Screening?

American Cancer Society: Smoking at an All-Time Low, but Other Behavioral Risk Factors Are a Problem

What’s New Cigarette smoking rates reached an all-time low in 2019, but other modifiable lifestyle factors that contribute to cancer risk need improvement, according to highlights from the American Cancer Society’s Biannual Cancer Prevention and Early Detection Facts & Figures 2021–2022 report. The report was publicly released on May 19. Research Details According to the new report, 14 percent (34 million) of the U.S. population smoked and roughly 62 percent (55 million) of people who had ever smoked had quit in 2019. The number of people who stopped smoking was lower among those with a high school education or lower, LGBTQ populations, recent immigrants, and residents of 12 of 17 Southern U.S. States. But the report also highlights the fact that other lifestyle factors that influence cancer risk are being ignored by a large swath of the population. For example, obesity (a known risk factor) continues to climb, especially among younger adults (42 percent of people age 20) and Black American women (57 percent). At the same time, only 54 percent of adults achieve recommended levels of physical activity, which lowers risk, and only 23 percent of high school students meet a minimum of 60 minutes of activity per day. Alcohol consumption, which increases risk, is also up, with roughly 5 percent of adults reporting heavier (more than seven drinks a week) amounts in the past year. Why This Matters The American Cancer Society (ACS) report highlights that 45 percent of the estimated 608,570 deaths from cancer projected for 2021 are from potentially preventable causes. While cigarette smoking accounts for 30 percent of all deaths from cancer, the remainder can be attributed to factors like obesity, lack of physical activity, an unhealthy diet, and alcohol consumption combined. Substantial racial and socioeconomic disparities also exist. RELATED: Latest Developments in Cancer Research and Treatment for April 2021

Sugary Drinks May Be Key to Early Colon Cancer in Women

What’s New Drinking two or more servings of sugar-sweetened beverages (SSBs) every day may be an underlying reason for an increase in colon cancer cases among women younger than 50 years (also known as early-onset colon cancer), according to a study published online in the May 6 issue of Gut. Research Details Researchers assessed how frequently beverages (including SSBs) were consumed in a group of 95,464 women who participated in the ongoing Nurses Health Study II between 1991 and 2015. Participants were asked to complete food frequency questionnaires every four years for a total of 24 years. SSBs were defined as carbonated or non-carbonated drinks with sugar (e.g., soft, fruit, and sports drinks, and sweetened tea). Average beverage consumption was also assessed in a subgroup of 41,372 participants who had similarly reported intake frequency and amounts when they were between the ages of 13 and 18. The findings showed that women who drank two or more 8-ounce (oz) SSB servings per week had roughly twice the risk for developing early-onset colon cancer compared with those consuming less than one 8 oz serving per week. In addition, each additional serving per day in women was associated with a 16 percent increased risk for early-onset colon cancer, while the same additional amount consumed by girls ages 13 to 18 upped risk by 32 percent. Conversely, replacing SSBs with artificially sweetened beverages, coffee, or reduced or total fat milk was associated with a 17 to 36 percent lower risk. Why This Matters Early-onset colon cancer is rising among younger adults, accounting for roughly 12 percent of all cases according to the ACS. Although researchers are still teasing out the reasons for this increase, SSB intake in adolescence and adulthood appears to be one possible driver and one that can be easily modified. RELATED: Chadwick Boseman’s Death Highlights Changing Trends in Colorectal Cancer

Few Racial, Ethnic Minorities Included in Pancreatic Cancer Research Despite Worse Outcomes

What’s New Although Black Americans, Hispanics, American Indians, and Alaska Natives are at higher risk for developing pancreatic cancer at a younger age and die earlier than their white peers, they are underrepresented in pancreatic cancer research trials, according to data presented at the Digestive Disease Week Virtual Meeting on May 23. Research Details Researchers from the University of Florida College of Medicine in Gainesville and Virginia Commonwealth University College of Medicine in Richmond reviewed data from 207 pancreatic clinical trials enrolling 13,448 participants. While 99 percent of trials reported gender-based findings, only 46 percent of trials reported race-based findings, and only 34 percent reported findings based on ethnicity. Compared with white patients (who comprised 83.4 percent of trial participants) and Asian patients (whose representation equaled the national population), Black Americans made up only 6.4 percent of trial participants, while American Indians and Alaska Natives comprised less than .1 percent. Why This Matters Pancreatic ductal adenocarcinoma is the most common type of cancer affecting the pancreas and accounts for about 90 percent of cases. It is especially deadly, with only 9 percent of patients surviving five years after diagnosis. But there are differences in the way the disease presents when it comes to race and ethnicity. For example, Black American patients, in particular, have different rates of genetic mutations related to the cancer compared with white peers, meaning they respond differently to treatment. These differences can’t be fully teased out without better representation in trials. RELATED: ‘Jeopardy!’ Host Alex Trebek Dies After Pancreatic Cancer Diagnosis

Moderate Hair Relaxer Usage Does Not Increase Breast Cancer Risk in Black Women

What’s New There’s no clear evidence that moderate use of hair relaxers increases the risk for estrogen-receptor-positive (ER+) breast cancer in most Black American women, according to a study published on May 20 in the journal Carcinogenesis. Heavy use of lye-containing products may increase risk, but further research is needed. Research Details Boston University researchers compared incidence of breast cancer among 50,543 women participating in the ongoing Black Women’s Health Study who reported moderate (three to six times a year), heavy (seven or more times a year), light (two or fewer times a year), or no use of hair relaxer. Among all participants followed for 17.8 years, 2,311 women developed breast cancer. Overall breast cancer risk was similar for heavy vs. light/never use (about 22 percent), as was the risk for ER+ vs. ER- breast cancer. What’s more, the findings did not show any significant trends when the data was separated out by years, frequency, age at first use, or number of burns resulting from use. However, women reporting use of lye-containing products (approximately 20 percent of the women participating in the study) had a roughly 30 percent increased risk for ER+ positive breast cancer compared with light/never users. Why This Matters Previous studies suggesting a link between use of hair relaxers and breast cancer in Black American women are based on the hypothesis that certain hormonally active compounds in these products may be absorbed through the scalp or scalp burns. While there is evidence that some chemicals (e.g., parabens, phthalates) can disrupt endocrine levels, and that relaxers and hair oils may cause early menstruation (a risk factor for breast cancer), evidence confirming a link to breast cancer is lacking. RELATED: What Black Women Should Know About Metastatic Breast Cancer