Updated Screening Guidelines for Colorectal Cancer

Last year, the American Cancer Society (ACS) updated the guidelines for colorectal cancer screenings due to a rise in cases among young and middle-aged people. For those of average risk, the ACS now recommends that screenings start at age 45 instead of the previous recommendation of 50. As we celebrate Colorectal Cancer Awareness Month, we are sharing information about colorectal cancer screenings and why it’s so important to stay current on your preventive care.

In May 2021, the U.S. Preventive Services Task Force issued new recommendations for colorectal cancer stating that people at average risk should start screening at age 45, which prompted Live360 Health Plan to change its guidance to cover testing at a younger age. 

The recommended age was lowered from 50 to 45 because colorectal cancer cases are on the rise among young and middle-aged people. Deaths of people under age 55 increased 1% per year from 2008 to 2017, even though overall colorectal cancer rates have dropped.

Colorectal cancer is most treatable when found early. Colonoscopies not only detect the disease, but also prevent cancer because precancerous polyps can be removed during
the procedure.

Guidelines for screening:

  • Starting at age 45, individuals with an average risk of colorectal cancer should undergo regular screening with one of six different tests, depending on patient preference and test availability. These tests include a FIT (Fecal Immunochemical Test) or gFOBT (Guaiac-based Fecal Occult Blood Test) every year, stool DNA test every three years, a CT colonography or flexible sigmoidoscopy every five years, or colonoscopy every 10 years. The recommendations do not prioritize any one test over another.
  • Following a positive result from a non-colonoscopy screening test, a timely follow-up colonoscopy must be performed to prevent cancer.
  • Average-risk adults in good health should continue colorectal cancer screening through age 75.
  • For patients between 76 and 85, screening decisions should be made jointly with clinicians based on patient preferences, life expectancy, health status, and prior screening history.
  • Individuals over age 85 should be discouraged from continuing screening.
  • People with a higher risk of colorectal cancer, such as a family history, should ask their physician to determine the best age to start screening.

Colorectal cancer is expected to cause about 53,000 deaths in 2023, according to the ACS. Prevention and early detection are key to staying healthy. If you have questions or are unsure when to schedule your next (or first) colonoscopy, talk to your primary care provider.