smiling middle aged patient looking at doctor

Recommended Age for Cancer Screenings Changed to 45

Who should go for routine colorectal cancer screenings?

Everyone age 45 and older should get a screening.

A colonoscopy is the only test that will remove polyps from the colon and prevent cancer. In early 2021, the American Cancer Society updated their recommendations to start routine colorectal screening with colonoscopy at age 45 for individuals at average risk. For those with an increased risk such as a family history of colorectal cancer, the age may be younger and should be discussed with your gastroenterologist. If someone in your family has had colon cancer, you are at higher risk for developing the disease, and that means a father, mother, brother or sister, your risk is two and a half times the average population risk.

The new recommendations apply to all adults age 45 to 75 without symptoms and who are at average risk for colorectal polyps and cancer. Factors indicating increased risk, such as personal or family history of colorectal polyps or cancer, warrant enhanced screening. The recently issued guidelines recommend that colorectal cancer screening start at age 45 (Lowered from age 50). Colon Cancer is the third leading cause of cancer deaths. Early screening and detection are the key to eradicate a cancer that is largely preventable.

Colorectal cancer is the second leading cause of cancer deaths in the U.S.

One in 10 colon cancer patients are being diagnosed before the age of 50, and the incidence rate has been increasing for people younger than 50 while decreasing in older individuals. Experts have reported fewer older Americans are being diagnosed with colorectal cancer and that this could be in part because there is better adherence to screenings, but it remains unclear as to why doctors are seeing an uptick in younger patients.

What drove the decision to lower the colorectal cancer screening guidelines to age 45 from 50?

This decision is based on an increasing trend of younger people—younger than age 50—being diagnosed with colorectal cancer, and at times, presenting with advanced disease. It is rare but we can see someone as young as 20 with colorectal cancer. The fact remains that young people, under the age of 50, are getting colon and rectal cancer more frequently now and the rate seems to be going up exponentially.

For those of us that are seeing younger patients with colon cancer, it’s particularly alarming because each case is a tragedy. It’s a tragedy that they get the cancer in the first place and then because nobody is suspecting it, the diagnosis is often delayed. It allows the disease to become more advanced and significantly decreases the chances for cure. The significance of the official lowering of the screening age is that colonoscopy for cancer screening is now a covered benefit by insurance carriers at age 45.