When Should I Begin Having Regular Colorectal Cancer Screenings?

Colorectal cancer is the third most prevalent form of cancer globally and one of the leading causes of cancer-related death. As bad as it is, though, colorectal cancer is also one of the most preventable and curable cancers—if caught early. The secret is early and frequent screening, which will catch the disease in its earliest stage or, by detecting and having removed precancerous polyps, even prevent the disease from occurring in the first place.

As a GI cancer surgeon, I see patients quite often who ask:-

"When should I screen for colorectal cancer?"

The answer is based on age, personal and family history, and risk status.

In this article, we will discuss everything you should know about when to begin colorectal cancer screening, what is available, and how to estimate your individual risk.

Why Is Screening for Colorectal Cancer Important?

Colorectal cancer (CRC) may start life as polyps—tiny bumps on the lining of the inside of the colon or rectum. Some polyps, over time, develop into cancer. Years is how long it takes for this to happen, so that's ample time to catch and prevent them if screening is done regularly.

Early colorectal cancer does not have symptoms, and therefore "silent disease" is commonly used.

Early discovery guarantees an excellent treatment outcome with follow-through significantly increased.

General Guidelines: How and When Do You Begin Screening?

How old should you be when you screen routinely based upon your risk group.

The People are at Average Risk:

You possess no risk factors if:-

• You are neither first-degree relative of a case, nor personal history of precancerous colonic polyps.
• Neither personal nor family history of colorectal cancer or polyps
• Not be having a genetic syndrome such as Lynch syndrome or familial adenomatous polyposis
• Not be having a personal history of inflammatory bowel disease (IBD)

For people who are at average risk, the common practice is to begin screening at age 45.

This guideline was reduced from 50 to 45 years by premier health organizations such as the American Cancer Society owing to a growing alarming rate of colorectal cancer among young adults.

High-Risk Persons

There are certain individuals who are at higher or increased risk of getting colorectal cancer. If you fall into one of these groups, you might need to begin screening earlier and more often.

You're high-risk if:

• You have a first-degree relative with colorectal cancer or advanced polyps (especially a first-degree relative with a diagnosis at age 60 or younger)
• You have a personal history of colorectal cancer or certain types of polyps
• You have inflammatory bowel diseases (e.g., Crohn's disease, ulcerative colitis)
• You have an inherited genetic syndrome (e.g., Lynch syndrome, FAP)

In these situations, screenings can start as early as age 40, or 10 years before your relative was diagnosed—whichever comes first.

What Screening Tests Are There?

There are a few effective methods of screening for colorectal cancer. Each has its advantages, and the decision generally depends on your level of risk, your own preferences, and available resources within the medical community.

Colonoscopy (Every 5-10 Years)

Standard for CRC screening. A colonoscopy enables a physician to visualize the entire colon and rectum with a flexible tube that has a camera at its end. It is even capable of removing polyps and detecting them on the same day.

Stool Tests

• Fecal Immunochemical Test (FIT): Detects occult blood in stool; performed once a year.
• Fecal Occult Blood Test (FOBT): Also like FIT; performed yearly.
• Stool DNA Test (e.g., Cologuard): Picked up both blood and DNA changes; every 3 years.

Not invasive but might have to be followed by a colonoscopy if positive.

Flexible Sigmoidoscopy (Every 5 Years)

Looks only at the lower colon. Less invasive than a colonoscopy but less thorough.

CT Colonography (Virtual Colonoscopy, Every 5 Years)

A test using CT scans to visualize the colon without surgery. If polyps are detected, a routine colonoscopy will still be required to have them removed.

When to Stop Screening?

Most experts advise screening to age 75, if the person is in good health and has a life expectancy of greater than 10 years.

• Age 76–85: Case-by-case determination to continue screening based on present health and previous screening history.
• Age 85 and older: Routine screening is not usually advised, unless there are certain risk factors or symptoms.

What If You Have Symptoms?

If you have any of these symptoms, screening or diagnostic evaluation should be performed immediately, regardless of age:

• Abdominal cramping or pain that persists
• Hematochezia or bleeding per rectum
• Unexplained weight loss
• Alteration in bowel habits (diarrhea or constipation)
• Incomplete sensation of bowel movement

These symptoms could indicate colorectal cancer or another serious condition and should never be ignored.

Lifestyle and Risk Factors: What Else Affects Your Risk?

Even if you’re not at high genetic risk, your lifestyle choices can significantly influence your risk of developing colorectal cancer. These include:

• Diet high in red or processed meat
• Low fiber intake
• Smoking
• Heavy alcohol use
• Obesity
• Sedentary lifestyle

In addition to routine screening, maintaining a healthier lifestyle can lower your risk and enhance your overall GI health.

Why Early Screening Is Important

Colorectal cancer is usually highly curable when caught early. Based on research:

• The 5-year survival rate for localized colon cancer is more than 90%
• Survival rates plummet when cancer has spread

This makes screening not only a recommendation, but a possibly life-saving step.

Your Takeaway: Speak with Your GI Specialist

If you're not sure when or how to get screened for colorectal cancer, talk to a GI specialist or a cancer surgeon. They can help you:

• Assessing your individual risk
• Deciding on the type of screening that will suit you best
• Creating a regular screening routine
• Offering support and counseling in case of an abnormal finding

Final Thoughts

Colon and rectal cancer screening is the best method currently available to avoid cancer and find cancer early when it is most treatable. Beginning at the right age, selecting the best test, and following up on a regular basis can make you much less likely to have advanced disease and improve your chances of successful treatment.

Don't wait for symptoms. Act early. Consult your doctor today about arranging for your screening—and take an assertive step toward long-term wellness.