Colorectal Cancer Screening: Awkward Conversations That Save Lives

March is Colorectal Cancer Awareness Month, a time to honor those who have faced or are facing this devastating disease and to spread the word about the power of prevention.

While the topic may feel uncomfortable for some, colorectal health is critically important. Screening can uncover issues well before symptoms begin, leading to better outcomes and longer, healthier lives.

“Everyone Poops”

Parents often buy the children’s book Everyone Poops by Taro Gomi  to help demystify bowel movements and explain that they are a natural process. Starting at age 45, adults should understand that routine colorectal screening is also a natural part of life. A little embarrassment is worth the peace of mind that comes with knowing you are likely cancer-free. Making screening routine helps remove stigma and normalize an action that can save your life.

4 out of 100 Will Be Diagnosed

Colon and rectal cancers are the fourth most common types of cancer, with an estimated 154,000 new cases expected in 2026. They are also the second-deadliest form of cancer, killing nearly 53,000 each year. About four out of every 100 people will be diagnosed with colorectal cancer during their lifetime.

Symptoms often do not appear until the cancer has advanced. Screening can provide reassurance or, in the case of a colonoscopy, detect and remove pre-cancerous polyps before they become malignant.

Screening Greatly Reduces Risk

The American Society for Gastrointestinal Endoscopy first issued guidelines for routine screening colonoscopies in 2000. The benefit of screening was further expanded under the Affordable Care Act, which requires most insurance plans to cover certain preventive services, including colonoscopies and other stool-based testing options, at no cost to patients.

Today, more than 15 million colonoscopies are performed each year. Screening reduces the risk of death from the disease by more than 60%. Since 2000, colonoscopy rates have increased by approximately 250%.

45 is the new 50

In 2021, the U.S. Preventive Services Task Force lowered the recommended age to begin colorectal cancer screening from 50 to 45. One in 10 colorectal cancer cases is diagnosed in people younger than 50. Between 2000 and 2016, incidence among people ages 40 to 49 increased by nearly 15%.

If no concerning findings are discovered, screening should continue through age 75. The recommended frequency depends on the type of test selected and previous results.

For adults ages 76 to 85, screening decisions should be made through a conversation between patient and physician, taking into account overall health, prior screening history and personal preferences.

Pick the Screening Option That’s Right for You

Colonoscopy is considered the gold standard for detecting colon and rectal cancer. However,  the preparation required for the procedure may be a barrier for some individuals.  For patients at average risk, choosing a screening method should be a shared decision between patient and healthcare provider. The most important step is to get screened regularly.

The American Cancer Society outlines screening options and recommended intervals as follows:

Stool-based home tests:

• Fecal immunochemical test (FIT) — every year
• Highly sensitive guaiac-based fecal occult blood test (HSgFOBT) — every year
• Multitarget stool DNA test (mt-sDNA) — every three years

Visual (structural) exams of the colon and rectum:

• Colonoscopy —  every 10 years
• CT colonography (virtual colonoscopy) —  every five years
• Flexible sigmoidoscopy —  every five years

Any abnormal result from a non-colonoscopy test should be followed by an immediate colonoscopy.

The Colorectal Cancer Alliance also offers this helpful quiz to provide personalized screening recommendations based on individual risk factors.

New Therapies Available in Community Settings

Treatment for colon and rectal cancer continues to evolve, with advances in chemotherapy, immunotherapy and targeted therapies improving outcomes. Innovative research and treatment are taking place not only in major metropolitan centers but also in community-based settings. Community research programs allow patients to access promising therapies close to home without compromising quality of care.

Make the Right Choice to Get Tested

Colorectal cancer is highly preventable, yet thousands of lives are lost each year because screening is delayed or avoided. Whether through colonoscopy or at-home stool tests, regular screening can detect cancer early or prevent it altogether by identifying and removing precancerous polyps.

With multiple testing options available and screening now recommended starting at age 45, the most important decision is simply to get tested.