When Should You Start Colon Cancer Screenings?

July 2021

Years ago, doctors may not have mentioned colorectal cancer prevention until a patient’s 50th birthday. But now, both the U.S. Preventive Services Task Force (USPSTF) and American Cancer Society (ACS) advise people with an average risk for colorectal cancer to begin regular screening at age 45. If you’re wondering why, here’s what you need to know.

The latest guidelines

News reports often focus on individual studies. Yet no single study tells the whole story. That’s why experts base health guidelines on a careful review of all the relevant research. Based on the overall evidence, here’s what both the USPSTF and ACS say:

• If you’re age 45 to 75 and have an average risk of developing colon cancer, get screened regularly.

• If you’re age 76 to 85, talk with your provider about whether to continue screenings.

• If you’re 86 or older, screening is not recommended.

If you’re at an increased risk for colon cancer and younger than age 45, ask your healthcare provider when to begin screenings. Risk factors include having inflammatory bowel disease or a personal or family history of colon cancer or polyps. Polyps are abnormal growths that might turn into cancer later.

The best test for you

Screening can help catch colon cancer early, when treatment works best. Even better, when polyps are found and removed, cancer can be prevented from starting in the first place. Providers may use various tests to check for colon cancer or polyps:

• Stool tests look for blood or altered DNA in a stool sample.

• Flexible sigmoidoscopy is a procedure in which the provider uses a short lighted tube to look at your rectum and lower colon.

• Colonoscopy is a similar procedure to flexible sigmoidoscopy in which the provider uses a longer lighted tube to look at your rectum and entire colon.

• CT colonography uses X-rays and computers to create images of your entire colon.

Each test has its pros and cons. Talk with your provider about which test is right for you and how often to have it done.