Americans Are Waiting Too Late To Screen for Colorectal Cancer—Here’s When You Should Start
An expert in colon cancer says getting screened at this age could lower your chance of death by 77%—and that a colonoscopy may not be the only method to find out.
The average age when adults in the US are getting their first screen for colorectal cancers, according to data from AMSURG? Fifty-eight.
The average age when most adults in the US should be getting their first screen for colorectal cancers, according to the American Cancer Society? Forty-five.
That 13-year gap could be the difference between life and death, says Folasade May, MD, co-leader of the Stand Up To Cancer Colorectal Cancer Health Equity Dream Team, a gastroenterologist and associate professor of medicine, David Geffen School of Medicine at UCLA, and a member of Fight Colorectal Cancer’s Medical Advisory Board. (And that’s not even including the nearly 40% of Americans who aren’t getting screened at all.)
“The one thing I wish more people understood is that most colorectal cancers cause no symptoms—none at all—in the early stages, when it’s easily treatable,” she says. “So the only way you would know if you have it is through a routine screening.”
This is so important because colorectal cancers caught in the early stages, when the cancer is still localized, have over a 90% survival rate. On the other hand, those that aren’t diagnosed until the later stages, when the cancer has spread to other parts of the body, have a survival rate of just 13%.
“The tragic news is that only about one in three cases are caught in the early stage, and it doesn’t have to be that way,” says Dr. May. “The screenings are highly accurate—but they can’t work if you don’t get them.”
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What age should you start getting screened for colorectal cancer?
The American Cancer Society recommends that, on average, people should get their first screening at age 45.
“However, if you have a family history of colorectal cancer, you should start screenings at age 40, or 10 years earlier than the youngest age one of your near relatives was diagnosed,” says Dr. May. So, if your father was diagnosed with colorectal cancer at age 42, you should start being screened at age 32.
In addition, if you experience any of the main symptoms of colorectal cancer—blood in the stool, anemia, unexplained weight loss, fatigue—you should get screened right away, regardless of age.
To help you do the math and understand your individual risk, Fight Colorectal Cancer has developed an online screening quiz.
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Who needs to get screened for colon cancer?
In short: Everyone.
“There’s a myth that this is an ‘old white man’s disease,’ but that couldn’t be more false,” says Dr. May.
Colorectal cancer affects women and men almost equally—and African Americans have the highest incidence and mortality rates from colorectal cancer of any ethnic group in the United States.
And while you are at a higher risk of getting it as you get older, that doesn’t mean that young people have no risk. In fact, in people younger than 50, rates of colorectal cancer have been increasing by one to two percent each year since the mid-1990s, according to the ACA.
Why don’t people get screened for colorectal cancer?
Even though colorectal cancer is the second-leading cause of cancer deaths, after lung cancer, in men and women combined, plenty of people still don’t know about it or the screening recommendations. It’s traditionally been one of the lesser-recognized types of cancer.
“There’s a huge stigma against colonoscopies in our society,” says Dr. May. “People have a real fear of both the prep and the procedure.”
She adds that financial concerns, lack of access to the procedure or to healthcare, and lack of knowledge are also big roadblocks that keep people from getting screened.
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What can you do if you’re afraid of getting screened for colorectal cancer?
Take a deep breath: While a colonoscopy isn’t necessarily fun, it’s likely not nearly as bad as you’ve heard. Generally, the pain is minimal, the recovery is short, and they’re very safe. Oh—and they could save your life.
“A very common fear we hear is that people are worried about their doctor seeing their bottom, but I want to reassure you that it’s very normal and we don’t think anything weird about it,” adds Dr. May. “This is what we are trained to do, and we are very professional throughout the procedure.”
Second, you should know that a colonoscopy is one type of screening but it’s not the only option. There are stool tests that only require you to provide a sample of your poop. And for people who prefer to go totally non-invasive, a CT (computed tomography) colonography scan uses a machine to take 3-D pictures of your colon.
While the colonoscopy is considered the gold standard, “The best test is the one that gets done,” says Dr. May.
If you have any fears or concerns, talk to your doctor about the type of screening method that will work best for you and your individual concerns and risk factors.
When can you stop getting colonoscopies?
This isn’t a life-long need. Most people can expect to stop colorectal cancer screenings between 75 and 80 years old. By that point, they’re not likely to be your cause of death, and the risks of complications from colonoscopies go up in the very elderly, says Dr. May.
Schedule your colorectal screening today
No matter what your age, your cancer screening starts with talking with your doctor early and often about your family history, your lifestyle, your symptoms (if any) and other risk factors.
“Taking the time to get screened is the first step to putting your mind at ease—or if any abnormalities are found, it’s the first step in taking care of them,” she says.
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American Cancer Society: "All About Colorectal Cancer"
AMSURG: "Americans Are Waiting Too Long To Start Colorectal Cancer Screening"
Fola May, MD, a gastroenterologist and associate professor of medicine, David Geffen School of Medicine at UCLA and the director of Fight Colorectal Cancer.
American Cancer Society: "Key Statistics for Colorectal Cancer"
The American Journal of Gastroenterology: ACG Clinical Guidelines: Colorectal Cancer Screening 2021