Earlier Is Better: New Guidelines for Colon and Rectal Cancer Screenings

March 21, 2023

Stephen Cohen, MD, MBA

Colorectal cancer (cancer of the colon or the rectum) is on the rise in younger adults. As a result, the recommended age to begin screening for colorectal cancer has been lowered from 50 to 45. 

To learn more, we turned to Dr. Stephen Cohen, one of our First Stop Health urgent care doctors. Dr. Cohen is a board-certified colon and rectal surgeon who has been practicing in the specialty for 29 years.  


Let’s start with the basics. What are your colon and your rectum?  

Part of your digestive system, your colon and rectum are in the large intestine, helping you move waste out of your body. Your colon removes water, some nutrients and electrolytes from partially digested food.  After moving through the colon, the remaining material is stored in the rectum before exiting the body. 



What is colorectal cancer? 

For both men and women in the U.S., colorectal cancer: 

  • Is the third-most common cancer (excluding skin cancer)  
  • Is expected to cause more than 52,000 deaths in 2023 alone 

The good news is that, when caught early, colorectal cancer can be removed. Most colorectal cancers start as growths, called polyps, on the inner lining of the colon or the rectum. Not all polyps become cancer, but most do, so it’s important to get them removed once found. To detect these abnormal growths, a doctor can perform a colonoscopy, a screening procedure during which they look inside your colon and rectum.  


What causes colorectal cancer? 

The risk factors you can control include lack of physical activity, being overweight, using tobacco and drinking alcohol. If you need help making some changes, your primary care doctor can help. If your employer provides you with First Stop Health Virtual Primary Care, you can get personalized care via phone or video. Schedule your appointment today!   

Your risk is higher if you have a first-degree relative (parent, sibling or child) with a history of colorectal cancer or polyps. 



How can I prevent colorectal cancer? 

The most important thing you can do is follow your doctor’s advice on colorectal screenings. Remember, most colorectal cancer starts with an abnormal growth (a polyp), which you want to detect and remove as early as possible.  

Most studies suggest that you can reduce your risk of developing colorectal cancer by increasing your physical activity, keeping a healthy weight, avoiding tobacco and limiting your alcohol consumption. Again, your First Stop Health primary care doctor is here to help.  



What are the early symptoms of colorectal cancer? 

Colorectal polyps and cancer can exist without symptoms for quite some time – which is why screenings are so important. When symptoms do begin, they may include: 

  • A change in bowel habits 
  • Blood in your stool 
  • Diarrhea, constipation or a feeling that bowels don’t empty all the way 
  • Ongoing pain, cramps or aches in your stomach  
  • Unexplained weight loss 

If you’re experiencing any of these symptoms, schedule a visit with your primary care doctor. 



What are the recommended screenings? 

Screenings, which are tests used to look for a disease before a person has symptoms, are incredibly important! Screenings can find colorectal cancer early – when it’s easier to treat.  

Generally, current guidelines are to get screened at age 45 and then regularly up to age 75. However, you may need screenings earlier in life or more frequently if you have: 

  • A history of inflammatory bowel disease (including Crohn’s disease and/or ulcerative colitis)  
  • A family history of colorectal cancer or polyps 

There are a few different types of screenings: 

  • Stool Test: You collect a sample of your stool at home and send it to a lab for analysis.  
  • Colonoscopy: A doctor looks inside your colon and rectum using a small camera on a long, flexible tube.   
  • Virtual Colonoscopy: A doctor takes a series of x-ray images of your colon and rectum.  

The type of screening you need will depend upon your personal risk for colon cancer. Your doctor help you decide which screening is best for you.  



In the news lately, we’ve seen a lot about increased rates of colon cancer in young adults. What’s behind this?  

Right now, nobody really knows why the incidence of colorectal cancer is on the rise globally. 10% of new colorectal cancer diagnoses are in adults under 50. For this reason, the screening guideline has recently been lowered to age 45 for both men and women (instead of age 50).  

If you’re younger than 45, talk to your doctor if: 

  • You’re experiencing any of the symptoms I listed above  
  • You have a parent, sibling or child with a history of colorectal cancer or polyps



What do you wish everyone knew about colorectal health?

The good news about colorectal cancer is that it grows relatively slowly. It can take years for polyps to develop and then turn into cancer. Thanks to the colonoscopy, colorectal cancer is one of the few cancers we can prevent by simply removing abnormal growths.  

Screening for colorectal cancer saves lives.  




Need a primary care doctor? We’re here.  

If your employer or school offers you First Stop Health Virtual Primary Care, our doctors are here to provide care you will love. During your first visit, your doctor will get to know your personal and family health history, ask questions, listen to your concerns, and make recommendations for your current and future health.   

Schedule a Visit







Originally published Mar 21, 2023 8:35:27 PM.