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Unpacking the Revised Colonoscopy Screening Guideline

Last updated: March 7, 2023

With new information and advances in screenings and prevention, we hope to provide better outcomes for patients through early detection.

Dr. Matthias Weiss, Medical Research Director, ThedaCare Cancer Care

Nearly two years ago, leading national health organizations came together to recommend a new, younger age for beginning colonoscopy screenings. It represented an important step in responding to a troubling trend of increased prevalence of colorectal cancer among younger individuals.

In May 2021, national health organizations began recommending regular colon cancer screenings starting at age 45 — five years earlier than the previous recommended age of 50.

“We are encouraged by the updated screening guidelines,” says Dr. Matthias Weiss, Medical Research Director with ThedaCare Cancer Care. “With new information and advances in screenings and prevention, we hope to provide better outcomes for patients through early detection.” 

March is National Colorectal Cancer Awareness Month. According to the American Cancer Society, colorectal cancer is the third-leading cause of cancer death for both men and women in the U.S., and it’s the second most common cause of cancer deaths when numbers for men and women are combined. Each year, the U.S. sees more than 150,000 new cases of colorectal cancer, affecting all races and ethnicities.

Why Screen Younger?

An increased incidence of late-stage colon cancer in younger people led to the 2021 guideline change, Dr. Weiss says. The U.S. Preventive Services Task Force (USPSTF) notes that rates of colon cancer in 40- to 49-year-olds increased by almost 15% from 2000-2002 to 2014-2016.

“If you’re 45 to 75 years old, getting screened regularly is a key step in helping to prevent colorectal cancer,” Dr. Weiss says.

If you’re younger than 45 and you believe you might be at a higher risk for developing colorectal cancer, perhaps because of a family history of the disease, talk with your primary care provider about screening options and recommendations, he says.

If you do not have an increased risk of colorectal cancer and have a normal colonoscopy result, you can repeat a colonoscopy every 10 years.

Screening Options

According to Dr. Weiss, even though colonoscopy is considered the gold standard of screenings, you can choose from three main options for colorectal cancer screening.

  • Fecal occult blood test (FOBT): Checks for blood in the stool, which can be a sign of colorectal cancer.
  • Stool DNA test: Looks for DNA markers that indicate the presence of colorectal cancer.
  • Colonoscopy: Involves inserting a long, flexible tube into the rectum to visually inspect the colon for any abnormalities or cancer.

More than 15 million people undergo colonoscopies the U.S. each year. However, data from USPSTF shows that in 2016, 25.6% of eligible adults in the U.S. had never been screened for colorectal cancer, and in 2018, 31.2% were not up to date with their screenings.

Symptoms and Risk Reduction

Colorectal cancer might not cause symptoms right away. Symptoms can be non-specific, which is why regular screenings are important, Dr. Weiss says.

Symptoms of colon cancer include:

  • Rectal bleeding
  • Changes in bowel movements, such as constipation or diarrhea
  • Abdominal pain
  • Fatigue
  • Anemia
  • Unexplained weight loss
  • Decreased appetite

If you experience any of these symptoms, speak with a health care provider as soon as possible. Early detection and treatment have been shown to improve outcomes.

Colorectal cancer risk factors include a diet high in red meat and processed foods, a sedentary lifestyle, and smoking.

To reduce your risk, physicians recommend focusing on five key lifestyle habits:

  • Eat a Mediterranean diet rich in fruits, vegetables, whole grains, and high-fiber foods
  • Exercise regularly, which improves physical and emotional well-being and helps prevent unhealthy weight gain
  • Quit smoking
  • Limit alcohol consumption
  • Get a colonoscopy (even if you feel healthy) and other recommended cancer screening procedures

Scheduling a colonoscopy screening is easy.

Tags: 45 is the new 50 colonscopy colorectal cancer screening

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