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When should I get screened for colon cancer?

Doctor with a graphic of a healthy colon

When should I get screened for colon cancer?

The American Cancer Society recently updated its recommendations for colorectal cancer screenings. It used to be that people of average risk for colon or rectal cancer were advised to get their first colonoscopy at age 50. That guideline has now changed to age 45. So, if you’re nearing 45 or older, it’s time to think about scheduling a screening.

Why the change? Recent research has found that new cases of colorectal cancer are occurring in younger people at an increasing rate. Since colon cancer often shows no early symptoms, the only way to detect it is with a screening exam.

In addition to starting regular screening at age 45, the American Cancer Society recommends people in good health with a life expectancy of more than 10 years should continue to get regular colorectal cancer screening exams through age 75. After that, they recommend talking with your primary care provider about the pros and cons of screening based on your personal preferences and overall health. People over age 85 are no longer advised to get a colorectal cancer screening.

There are a few options for screening exams, and you should talk with your provider to determine which one is right for you. The most common visual exam is the colonoscopy, which involve inserting a scope inside the body to capture images of the colon. These are recommended every five to 10 years after the initial exam at age 45. Some stool-based lab tests are also available to help detect signs of cancer, including the highly sensitive fecal immunochemical test (FIT) and the guaiac-based fecal occult blood test (gFOBT), which doctors recommend getting every year after your first visual screening. In addition, your provider may suggest getting a multi-targeted stool DNA test (MT-sDNA) every three years.

For people at higher than average risk, including those with a personal or family history of colorectal cancer, polyps, or inflammatory bowel disease, doctors may advise getting screened earlier than age 45, or more frequently once you reach your 40s and 50s. Talk with your primary care provider about which screenings are right for you.

Dr. Nelson is board-certified in general surgery and sees patients at Asante General and Colorectal Surgery.

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