45 & Alive! Colon Cancer Screening Starts at 45

Colorectal cancer screening seems complicated, even kind of gross – but it doesn’t have to be!

When it is one of the leading causes of cancer death in the United States, screening saves lives, says Joseph Daprano, MD, a MetroHealth Internal Medicine physician. Given the uptick in cases among younger adults, the age for first screening is now 45, down from 50. Here’s what you need to know.

What is colorectal cancer screening?

These tests check for cancerous cells in both your colon and rectum (part of your large intestine). When cancer is found in your colon, it’s called colon cancer. On your rectum, it’s called rectal cancer.

About 1 in 23 men and 1 in 26 women will develop colorectal cancer. Compared with other races, Black people face an increased risk of colorectal cancer. All adults at average risk of colon cancer should begin colorectal cancer screening starting at age 45.

What are the screening options?

Fecal immunochemical test (FIT) 

This at-home test looks for blood in your stool, which could indicate a problem. Any MetroHealth patient who is eligible for colon cancer screening automatically gets FIT test in the mail each year. Follow the instructions to collect your stool sample and return it in the postage paid envelope provided. Within a week or two, you’ll get your results. If the test finds blood, then you need to have a colonoscopy.

Cologuard

This at-home test also looks for blood in your stool, in addition to checking for DNA changes in stool cells. If blood or DNA results are found that indicate the possibility of colorectal cancer, your provider will refer you for a colonoscopy.

Colonoscopy

This is the gold standard for colorectal cancer screening and prevention. During a colonoscopy, a doctor can find pre-cancerous polyps and remove them — preventing cancer. You’ll get instructions on prep, which will involve consuming a liquid-only diet for a day, and then drinking water mixed with a prescribed substance that helps you “clear out” your colon the night before the procedure. During the procedure, you’ll be sedated while a gastroenterologist inserts a thin flexible tube fitted with a tiny camera into your rectum. The doctor looks for any polyps or other signs of cancer. Any polyps are removed and tested immediately. If your colonoscopy is clear, then you don’t need another for 10 years.

Your Questions Answered

Q. Why should I start colon cancer screening at age 45?

A. Colon cancer is becoming more common in younger adults. Starting screening at age 45 can help find colon cancer early, when it is easier to treat. Screening can also find and remove polyps before they turn into cancer.

Q. What are my options for colon cancer screening?

A. There are several screening choices. A colonoscopy is the most common and can find and remove polyps during the same procedure. Some people may qualify for at-home stool tests. Talk with your healthcare provider about which option is best for you.

Q. Do I need screening if I feel healthy and have no symptoms?

A. Yes. Colon cancer often does not cause symptoms in its early stages. That's why screening is so important. Even if you feel well, getting screened at the recommended age can help protect your health and possibly save your life.