Colorectal Cancer

Colorectal cancer is cancer of the colon or rectum. With certain types of screening, this cancer can be prevented by removing polyps (grape-like growths on the wall of the large intestine, which is part of the colon) before they become cancerous. Colonoscopies or stool-based tests can also detect the disease early when treatment is more likely to be successful.

In 2021, the U.S. Preventive Services Task Force (USPSTF) lowered the recommended colorectal cancer screening age from 50 to 45. Though colorectal cancer is seen more often in people ages 50 and over, diagnoses in the 50+ age group have decreased in recent years due to more people getting screened and fewer people smoking. For reasons that are not understood, colorectal cancer incidence and deaths are steadily rising in adults younger than age 50.

Black people are more likely to develop colorectal cancer and more likely to die from it than most other racial or ethnic groups.

Visit Too Young for This Sh*t for more information on colorectal cancer in younger adults

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Screening

Start getting screened at age 45 if you’re at average risk for colorectal cancer.⁺ If you’re at increased risk, you may need to start regular screening at an earlier age and/or be screened more often.

Continue screening through age 75 if you are in good health, with a life expectancy of 10 years or more. If you are age 76–85, talk with your health care provider about whether to continue screening. After age 85, you should not get screened.

There are several options available for colorectal cancer screening. See the chart below and talk with your health care provider about which screening is right for you.

Test	Screening Interval
Colonoscopy	Every 10 years
Virtual colonoscopy*	Every 5 years
Flexible sigmoidoscopy*	Every 5 years
High sensitivity guaiac based fecal occult blood test (HS gFOBT)*	Every year
Fecal immunochemical test (FIT)*	Every year
Multitarget stool DNA test (mt-sDNA)*	Every 3 years

⁺‘Average risk’ means you do not have:

A personal history of inflammatory bowel disease (such as ulcerative colitis or Crohn’s disease).
A personal history of colorectal cancer or certain kinds of polyps (“flat polyps”).
A family history of colorectal cancer.
Hereditary colorectal cancer syndrome (such as familial adenomatous polyposis (FAP) or Lynch syndrome).

*An abnormal result of a virtual colonoscopy or flexible sigmoidoscopy, a positive FOBT, FIT or sDNA test should be followed up with a timely colonoscopy.

What Puts You at Risk for Colorectal Cancer?

You are at increased risk for colorectal cancer if you:

Are age 50 or older.
Smoke.
Are overweight or obese, especially if you carry fat around your waist.
Have Type 2 diabetes.
Are not physically active.

Drink alcohol in excess, especially if you are male.
Eat a lot of red meat (such as beef, pork or lamb) or processed meat (such as bacon, sausage, hot dogs or cold cuts).
Have a personal or family history of colorectal cancer or colorectal polyps.
Have a personal history of inflammatory bowel disease (such as ulcerative colitis or Crohn’s disease)

Reduce Your Risk

Exercise at least 30 minutes, at least 5 days a week.
If you drink, limit your drinking to no more than one drink a day if you are a woman, and no more than one or two a day if you are a man. Drinking alcohol is linked to colorectal and several other cancers. The more you drink, the greater your risk of cancer. Even drinking small amounts might increase your risk.
Do not smoke or use tobacco in any way. If you do, quit.
Eat less red meat and cut out processed meat.

Maintain a healthy weight and waist size.
Eat lots of fruits, vegetables, beans and whole grains.
Get screened according to guidelines.

The recommended age to begin colorectal cancer screening for those of average risk changed from 50 to 45 in 2021.

The rate of colorectal cancer in people younger than 50 continues to steadily rise.

Symptoms

Bleeding from the rectum or blood in or on the stool
Change in bowel movements
Stools that are more narrow than usual
General abdominal problems such as bloating, fullness or cramps
Diarrhea, bleeding or constipation or a feeling in the rectum that the bowel movement is not quite complete
Weight loss for no apparent reason
Feeling very tired all the time
Vomiting

Treatment Options

Surgery is the most common treatment. When the cancer has spread, chemotherapy or radiation may be administered before or after surgery.