Colorectal cancer is the second leading cause of cancer-related deaths in the United States. While this statistic is alarming, the good news is that colorectal cancer is one of the few cancers with effective screening tests that can detect and prevent the disease early. However, many people hesitate to undergo screenings due to concerns about discomfort and preparation requirements.
Thanks to advancements in screening methods, guidelines, and preparation techniques, the process has become more accessible and patient-friendly. If you’ve been avoiding a colorectal cancer screening, now is the time to reconsider, especially since recommendations for screenings have changed.
New Guidelines: Why Has the Recommended Screening Age Dropped from 50 to 45?
One of the most significant changes in colorectal cancer screening guidelines is the lowered recommended starting age. Previously, adults at average risk were advised to begin screenings at age 50, but the American Cancer Society (ACS) now recommends starting at age 45.
Why Was This Change Made?
Research has shown a concerning increase in colorectal cancer cases among younger individuals. According to the ACS, while the incidence rate has declined in individuals over 65, it has been rising steadily in younger age groups, including those between 20-39 and 40-54 years old. In fact, the ACS reported in 2020 that approximately 18,000 cases (12% of total diagnoses) occurred in individuals under 50. Lowering the screening age aims to catch cases earlier and improve survival rates.
Are You at Average or High Risk for Colorectal Cancer?
Determining your risk level is essential in deciding when to start screenings. You are considered at average risk if you do not have any of the following high-risk factors:
- A strong family history of colorectal cancer or certain polyps.
- A personal history of colorectal cancer or polyps.
- Ulcerative colitis or Crohn’s disease.
- A family history of genetic syndromes like Lynch syndrome or familial adenomatous polyposis.
- Radiation treatment to the pelvis or abdomen for previous cancer.
If you have any of these risk factors, your doctor may recommend starting screenings before age 45 and undergoing more frequent tests.
Screening Guidelines for Different Age Groups
The ACS provides specific guidelines on how long screenings should continue based on age and health status:
- Ages 45-75: Those in good health and with a 10-year life expectancy should undergo regular screenings.
- Ages 75-85: Screening should be based on an individualized health assessment. Discuss with your doctor whether you need continued screenings.
- Age 85 and older: Routine screenings are not recommended.
Colorectal Cancer Screening Options
There are multiple screening methods, ranging from stool-based tests to visual colon examinations. Your choice should depend on factors like comfort level, accuracy, and risk assessment.
Stool-Based Tests
Stool-based tests check for blood or DNA changes in your stool that could indicate colorectal cancer. While these tests are non-invasive, they may not detect polyps, which can develop into cancer over time.
- Fecal Immunochemical Test (FIT) – Done annually.
- Guaiac-based Fecal Occult Blood Test (gFOBT) – Done annually.
- Stool DNA Test (Cologuard®) – Done every 3 years.
Visual Exams of the Colon
Visual screenings not only detect cancer but also identify precancerous polyps, which can be removed before they develop into cancer.
- Colonoscopy: Considered the gold standard, performed every 10 years.
- CT Colonography (Virtual Colonoscopy): Done every 5 years.
- Flexible Sigmoidoscopy: Examines part of the colon, done every 5 years.
If a stool-based test or visual exam detects abnormalities, a follow-up colonoscopy is necessary for further examination and potential polyp removal.
How to Schedule a Colorectal Cancer Screening
Screenings are typically performed by gastroenterologists, general surgeons, or colorectal surgeons. If you are scheduled for a colonoscopy, here’s what to expect:
- Initial Consultation: A specialist will review your medical history, medications, and family history.
- Scheduling the Procedure: A surgery coordinator will help you book an appointment.
- Preparation Instructions: You will receive detailed guidelines on diet and bowel prep before the procedure.
The Bottom Line
Early colorectal cancer screenings save lives. With updated guidelines and more accessible screening options, there’s no reason to delay your test. If you’re 45 or older, talk to your doctor today about scheduling a screening and taking a proactive step in protecting your health.
Frequently Asked Questions:
1. At what age should I start colorectal cancer screening?
The American Cancer Society recommends starting at age 45 for those at average risk. If you have high-risk factors, you may need to start earlier.
2. Is a colonoscopy the only way to screen for colorectal cancer?
No, there are several options, including stool-based tests (FIT, gFOBT, and stool DNA tests) and visual exams like CT colonography and flexible sigmoidoscopy.
3. What is the best colorectal cancer screening method?
A colonoscopy is the most comprehensive test because it can detect and remove polyps. However, stool-based tests are also effective and non-invasive alternatives.
4. How often do I need a colorectal screening?
It depends on the test type. Colonoscopy is done every 10 years, FIT and gFOBT annually, and stool DNA tests every 3 years.
5. What should I expect during a colonoscopy preparation?
You’ll need to follow a special diet and bowel preparation regimen before the procedure to clear your colon for accurate results.
