You may need to begin colorectal screening at 45

The latest news on colorectal cancer is mixed. While the five-year survival rate for these cancers has increased to 63 percent, diagnosis of malignancies is on the rise in those under 55 years of age.  

In fact, Americans born in 1990 have twice the risk of colon cancer and four times the risk of rectal cancer as those born in 1950. People younger than 55 are also more likely to be diagnosed with late-stage colorectal cancer.  

“It’s becoming more and more well-known that the new screening age is 45 – and that’s changed from 50,” Dr. Anthony D’Andrea, Assistant Professor in UTMB’s Section of Colorectal Surgery, Department of Surgery, said.  

Patients with genetic risks such as Lynch Syndrome, family history of cancer or inflammatory bowel diseases should ask their providers about even earlier screening.  

Because colorectal polyps can take 10 or 15 years to develop into cancer, earlier screening and removal of polyps are recommendations that respond to the increased risks for younger people.  

Common signs and symptoms of colorectal cancer  

  1. Change in bowel habits that lasts more than a few days 
  1. Narrowing of the stool 
  1. An urge to move bowels that is not relieved by doing so 
  1. Rectal bleeding 
  1. Dark stool or blood in the stool 
  1. Cramping or abdominal pain 
  1. Weakness and fatigue 
  1. Unintended weight loss 

Because rectal bleeding can be a sign of benign conditions like hemorrhoids, people often don’t consult their healthcare team. 

“A young patient will go a year with bleeding without having had a colonoscopy,” D’Andrea said. “By the time they finally get a colonoscopy, it’s often stage three or four cancer.”  

Patients who have these symptoms or who are 45 or older and have delayed or missed their colonoscopy should contact a provider to arrange next steps.  

Some experts predict that colorectal cancers will be the leading cause of cancer deaths by 2030, so regardless of age, there are preventative actions anyone can try.  

Six tips for preventing colorectal cancer

  1. Get screened for colorectal cancer beginning at 45 – younger if you have certain risk factors. Finding these cancers increases likelihood of successful treatment. People with familial history of cancer, certain genetic syndromes or inflammatory bowel diseases should ask their providers about earlier screening.  
  1. Eat lots of vegetables, fruits, and whole grains. Diets that include lots of vegetables, fruits, and whole grains, and less red and processed meat have been linked with a decreased risk of colon or rectal cancer.  
  1. Get regular exercise. Being more active may help reduce your risk.  
  1. Take control of your weight. Being overweight or obese increases your risk of getting and dying from colon or rectal cancer. 
Anthony D'Andrea, MD, MPH

Dr. Anthony D'Andrea is an Assistant Professor in the Section of Colon and Rectal Surgery, Department of Surgery, at the University of Texas Medical Branch (UTMB) in Galveston, Texas.