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In Your 40’s? Don’t Forget This Life-Saving Screening

Now is the time to get a colonoscopy if you haven’t already done so. It can save your life!

Colorectal cancer is the third most common cancer in the United States, excluding skin cancers. It’s also the second leading cause of cancer death. You won’t always have symptoms of colorectal cancer, especially at its earlier stages, so screening tests are the best way to check for this very serious disease.

“It is so important to know your family's medical history,” says Sherri Schmidt, RN, BSN, Oncology Nurse Navigator with St. Joseph’s Cancer Institute. “You are three times more likely to get colorectal cancer if you have a family history. You are also more likely to  get colorectal cancer at an earlier age. Talk to your doctor about when screening is right for you.”

When should I begin screening for colorectal cancer?

Up until recently, it was recommended that adults begin screenings for colorectal cancer starting at age 50. But due to rising rates of colorectal cancer in people under the age of 50, the U.S. Preventative Services Task Force lowered screening age recommendations in 2021. They now suggest that adults at average risk for colorectal cancer begin screening at age 45. Some people may need to start screening younger than 45 if they are at an increased risk. Talk to your doctor about what’s right for you.

How are colorectal cancer screenings done?

The gold standard of colorectal cancer screening is a colonoscopy. This test is performed by inserting a thin flexible tube with a small camera into the rectum and through the colon, allowing doctors to check for polyps, tumors and other abnormalities. If polyps are found, they can be removed during the test. This is an important protection against colorectal cancer, because some polyps may become cancerous in the future.

Another test that is similar to a colonoscopy is a flexible sigmoidoscopy. This test is also done by inserting a thin tube into your rectum with a camera, but it only covers the sigmoid colon and does not go as far as a colonoscopy. However, the prep and the procedure itself may be easier for some people to tolerate.

Other non-invasive screening tests are also available to check for the possibility of colorectal cancer. They are easier to perform, but are not as definitive as colonoscopies. These tests, including fecal occult blood tests (FOBT), fecal immunochemical tests (FIT) and Cologuard, look for blood or abnormal DNA in the stool. The tests are not 100 percent accurate but are an option for people who don’t want to or can’t have a colonoscopy or sigmoidoscopy performed. Keep in mind, however, that negative tests may miss possible cancers. Positive tests will require a colonoscopy for further evaluation.

How often do I need to be screened for colorectal cancer?

If a colonoscopy shows no sign of cancer, polyps or abnormalities, it will typically be recommended that you repeat the test every 10 years until age 75. If polyps or abnormalities are found, it’s more likely you’ll be told to come back in 5 years. In some cases, you may need colonoscopies more often than that.

If you get a sigmoidoscopy, it may be recommended that you repeat the test every five years and have a fecal occult blood test (FOBT) done yearly.

Keep in mind that these are just general guidelines and the timing of your screenings may be different depending on factors that are unique to you, including findings from previous tests and your risk of developing colorectal cancer.

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Date Last Reviewed: January 18, 2024

Editorial Review: Andrea Cohen, Editorial Director, Baldwin Publishing, Inc. Contact Editor

Medical Review: Perry Pitkow, MD

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