When should you start screening for colorectal cancer? - Primary Health

When should you start screening for colorectal cancer?

  • October 13, 2023

  • Adi Chandrasekhar, MD, MPH, FACP

  • 2 minutes

colon cancer screening

More younger people are dying from colon cancer. Earlier screening and family history reviews can help reverse this trend.

Colorectal cancer is often viewed as a disease affecting the elderly but the reality proves more complex. While indeed much more common in those aged over 50, we’re seeing an alarming trend of increasing incidence in those below that age. The widely reported death of actor Chadwick Boseman from colorectal cancer at age 43 served as a tragic example of this trend. However, we must emphasize that despite its increasing incidence, it is still a rare disease in younger adults. 

Paradoxically, as we get better at screening older adults and thereby reducing their mortality from colon cancer, more younger people are dying from colon cancer. The National Cancer Institute reported that between 2012 and 2016, among adults aged 20-49, colorectal cancer was the deadliest cancer in men and the third deadliest in women. It is particularly problematic that most cases in younger adults are detected at more advanced stages because there is no routine screening offered to them. The United States Preventive Services Task Force (USPSTF) took note of this trend by recommending that screening for colon cancer be considered at age 45.

Experts attribute the increased incidence to various causes that include both genetic and environmental causes. In as many as a third of cases, underlying hereditary syndromes increase the risk of developing cancer. These syndromes include Familial Adenomatous Polyposis (FAP) and its variants, as well as Lynch Syndrome. These typically result in a family history of cancer that can be confirmed through patient history. Another condition known to increase risk for colon cancer is inflammatory bowel disease, which includes ulcerative colitis and Crohn’s disease. 

Family history determines colon cancer risk

Independent of these conditions, family history also serves as a useful tool to determine a patient’s risk. A positive family history is either a first-degree relative or two second-degree relatives diagnosed with colon cancer or precancerous polyps. In general, clinicians recommend that patients undergo screening tests at age 40 or ten years before the lowest age at which a family member was diagnosed with cancer, whichever comes first. 

All this can seem very scary. Happily, access to colon cancer screening has never been easier. Home-based stool tests provide an effective and easy way to screen for colon cancer. As a final note, home-based tests may not be suited for all high risk patients. These include people with family history or hereditary syndromes. Those patients often benefit most from a traditional colonoscopy.

Empowered with this information, talk to your doctor about the most appropriate colorectal screening for you! And if you need a home-based test, check out your options through Primary.Health.

Disclaimer: This blog content and linked materials are not intended as individual medical advice, diagnosis or treatment, and should not be considered as such. Any readers with medical concerns should contact a licensed healthcare provider. This blog is provided for informational purposes only.

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