Colorectal cancer screening recommendations
A 2017 study led by American Cancer Society (ACS) researchers revealed that new cases of colon cancer and rectal cancer are occurring at an increasing rate among young and middle-aged adults throughout the United States. That is part of the reason why the ACS and our cancer experts now recommend that for those with an average risk (no family history of colon cancer or other risk factors) colon and rectal screenings should take place at age 45, rather than the previous recommendation of 50. Patients with a first-degree relative, meaning a person's parent or sibling, diagnosed with colorectal cancer should start at age 40, or at 10 years younger than the age the relative was diagnosed.
Our colorectal cancer expert explains who should consider screening and when providing clarity for those considering screening.
Colorectal cancer screening options
Your doctor may detect cancer during a routine examination or during a colonoscopy or other screening exam. Sometimes, screening methods other than colonoscopies are a good option for a patient. We are sensitive to individual preferences and offer the full range of colorectal cancer screening tests. A doctor may order one or more of the following:
- Colonoscopy: a physician inserts a colonoscope (flexible tube with a camera and source of light) to evaluate the inside of the colon. The vast majority of colonoscopies are performed as part of screening for colon cancer. Physicians may order these exams as follow-up if we find the suspected cancer through a blood test or other screening tests. These give the doctor a clear view of your colon.
- Sigmoidoscopy: similar to a colonoscopy, the doctor is using a sigmoidoscope (flexible tube with camera and light) to evaluate the colon and the rectum. The physician is able to see the entire rectum but less than half the colon with this exam.
- Fecal occult blood test (FOBT): A lab test that checks stool for early colon and rectal cancer.
- Digital rectal exam (DRE): Your doctor inserts a lubricated, gloved finger to feel for cancer on the rectal wall.
- Endoscopy: A physician inserts an endoscope (a flexible tube with a camera) into the mouth to the rectum and colon, to view and remove any abnormalities on the colon’s inner lining.
- Carcinoembryonic antigen (CEA) test: This blood test measures the level of CEA. A higher than normal amount can be a sign of colorectal cancer.
- Rigid sigmoidoscopy: A doctor uses a stiff optical scope to measure a tumor’s distance from the anus.
- FIT (fecal immunochemical test) kit: This take home kit tests for hidden blood in the stool, which can be an early sign of cancer. If blood is found, then a colonoscopy would be recommended.
- Cologuard at-home test (Every three to four years for average-risk patients). With this non-invasive, DNA-based colorectal screening test, patients collect their stool in a kit provided by their physician and ship it to the lab to be tested.