New Guidelines Say Start Colon Cancer Screening at 45

Sep 13 • 2018
New Guidelines Say Start Colon Cancer Screening at 45

American Cancer Society Lowers the Age for Colon Cancer Screening

Colorectal cancer is the fourth most commonly diagnosed cancer in the United States, and it will claim the lives of about 50,000 people this year. New data indicate colorectal cancer rates are rising sharply among young and middle-aged Americans.

According to a study led by researchers from the American Cancer Society, the risk of colon cancer has doubled for adults born in 1990 compared to those born around 1950. Also, the risk for rectal cancer has quadrupled. Because of these findings, the American Cancer Society has lowered the recommended starting age for colon cancer screenings.

To understand why colon cancer is having a greater impact on younger generations and when people should start receiving colorectal screenings, we talked to Dr. Aleksander Jankov, medical oncologist and hematologist at the Baptist Cancer Center.

Who should be screened and why?

Certain groups, such as African Americans, have a greater risk of dying from colon cancer. However, research now shows younger generations have an elevated risk, despite race or ethnicity.

“The risk for colon cancer is rising for millennials and Generation X,” said Jankov. “This increased risk has influenced the American Cancer Society’s recent decision to update its colon cancer screening guidelines. It now recommends screenings begin at age 45 instead of 50.”

Researchers don’t know for sure why colon cancer rates are rising for younger generations, but lifestyle choices play a role.

“We’re living in a more sedentary time,” said Jankov. “We don’t move at work or exercise during our free time. We spend a lot of time on the couch watching Netflix, looking at Instagram feeds and doing a disservice to our bodies.”

In addition to exercising less, many people eat a diet of processed foods that are low in fiber and the vitamins necessary for colon health.

“Our food is energy dense,” said Jankov. “Our meals are less fibrous and don’t contain enough fruits and vegetables. Kids are growing up in an environment that doesn’t extoll the virtues of eating healthy or starting physical activity at an early age.”

What are colon cancer symptoms?

Because many young people are unaware of their risk for cancer, they delay following up on cancer-like symptoms. In fact, people younger than 55 years old are 58 percent more likely to be diagnosed with late-stage colon cancer, according to the American Cancer Society.

Jankov said it’s important to realize young adults can and do get colorectal cancer. People of all ages should learn colon cancer symptoms and alert their doctor if they experience painful or worrisome indicators, such as blood in the stool.

“It could be fresh, red blood or dark-looking stool,” said Jankov. “Other colon cancer symptoms include cramping, abdominal pain, unexplained anemia, weight loss and bloating.”

How do you prevent colon cancer?

While doctors can’t predict if you will develop colon cancer, you can take important steps to prevent the disease. According to Jankov, there are two main ways to prevent colon cancer.

“Primary prevention is living a healthy lifestyle,” said Jankov. “Eat wholesome foods that help maintain your reflex for a normal bowel movement every day. A Mediterranean diet full of healthy fats, fruits, vegetables, legumes and nuts can help you maintain good colon health.”

Secondary prevention involves detecting colon cancer early through screenings, such as high-sensitivity stool tests for traces of occult blood, a DNA stool test called Cologuard or a colonoscopy.

“The Cologuard test is a new approach to screening. You receive a kit in the mail from the company after your doctor orders it,” said Jankov. “You put your stool specimen in and return it to the company. It determines if there’s abnormal DNA in the stool that may indicate the presence of cancerous polyps.”

No matter which test you choose, it’s important to get regular screenings, especially if you are 45 years old or older or have an increased risk for colon cancer. People with a family history of colon cancer or a personal history of inflammatory bowel disease, polyps or prior cancer have a greater risk for colon cancer.

“When it comes to colon cancer, be proactive,” said Jankov. “Start living an active lifestyle today. Exercise, get screened and follow a healthy diet.”

Visit to learn more about colon cancer services at Baptist, or find a Baptist doctor by visiting our Find a Physician page.