March 4, 2022

Colorectal Cancer Awareness Month: When should you start screening?

Colorectal cancer awareness has grown over the past few years, especially among young people. Getting screened at a younger age can mean catching the cancer in an earlier stage, which could make it more treatable.

Colorectal cancer has gone through a rebranding campaign during the past few years thanks to awareness efforts not just during Colorectal Cancer Awareness Month, which takes place in March, but all year long.

These efforts have sought to reposition public thinking about cancers of the colon and rectum. “While these conditions were once considered problems for older people, awareness of the risk for colorectal cancer in younger people is growing,” said Michael Burke, MD, PhD, Hematologist/Oncologist at Mission Cancer.

Stories like that of actor Chadwick Boseman, who died at 43, have shed light on the growing incidence of this diagnosis in people between the ages of 30 and 40. In fact, according to the National Cancer Institute, the rate of colorectal cancer has more than doubled in people younger than 50 since the 1990s, even as rates have dropped among older adults.

While researchers don't know why rates have gone up only for young people, they know the value of catching tumors early, as cancers detected in earlier stages tend to be more treatable.

“That's why recommendations have recently changed to encourage people to get checked for colorectal cancer sooner. People of all ages should be familiar with these new recommendations as well as the signs and risk factors of this disease,” said Burke

Colorectal cancer: 3 quick facts to know

  1. Incidence
    Each year, about 150,000 people are newly diagnosed with colorectal cancer, which makes the disease the third most common cancer in the United States.
  2. Risk factors
    “While anyone can get colorectal cancer, certain factors can increase a person's risk. Some of these, such as lifestyle behaviors, can be controlled, while others can't,” said Burke. Risk factors for colorectal cancer include:
    • Smoking and alcohol use
    • Being overweight or obese
    • Being sedentary without regular exercise
    • Eating certain processed foods or red meats in excess
    • Personal or family history of colon cancer or polyps
    • Inflammatory bowel disease
    • Certain genetic changes, such as Lynch syndrome
    • Certain backgrounds, such as being an African American or an Ashkenazi Jew
  3. Symptoms
    Symptoms of colorectal cancer can resemble other common problems. Some signs of the condition include new changes in your bowel habits (like diarrhea or constipation), blood in the toilet bowl, pain in the stomach area and weight loss. If you have any of these concerns, don't hesitate to talk to your doctor.

According to Burke, not all colorectal cancers will cause symptoms early, which is why medical screening is the best early detection tool.

When and how often to get screened for colorectal cancer

“According to current medical guidance, the latest age when a person should start screening for colorectal cancer through stool-based testing or visual exams is 45 years old,” Burke said.

Sarah Cannon, the Cancer Institute of HCA Healthcare, recommends consulting your physician if you are 45 or older to determine the right screening test for you. Evidence-based options may include a colonoscopy at 10-year intervals or a fecal immunohistochemistry test (FIT) annually.
If you have close family members who have been diagnosed with colorectal or adenomatous polyps at an early age, you may need to have regular colonoscopies starting either at age 40 or when you're 10 years younger than your relative was when they were diagnosed. For example, if your parent had polyps detected at 45, your screening age might be 35.

However, these recommendations can be complicated and may vary widely based on your situation. Check with your Mission primary care doctor to determine what would be best for you so you can get timely and medically appropriate screenings as well as any genetic testing you might need to watch for colorectal and other cancers.

Prevention guidance to keep in mind

Many cancers are closely associated with lifestyles and behaviors like diet and exercise, but the links between unhealthy habits and colorectal cancer specifically are quite strong. In fact, one theory about why the incidence of colorectal cancer is up among young people is lifestyle-related: American diets and fitness levels have increasingly become unhealthy over the past several decades.

“Because your risk for colorectal cancer goes up with age, you can help create cancer-prevention habits early with a few simple changes, such as eating a balanced diet, getting more physical activity and quitting smoking if you're a smoker,” said Burke.

These tips may not eliminate your risk, but they could help lower it, and someday, that could make all the difference.