In a recent Sharecare poll, 64.5% of our newsletter readers named a <a href="https://www.sharecare.com/health/colonoscopy-diagnosis-colon-cancer/what-is-a-colonoscopy" target="_blank" title="Colonoscopy">colonoscopy</a> as the health test that makes them most squeamish, beating out Pap smears, blood tests and breast exams. Perhaps that &ldquo;eww&rdquo; factor is why, according to the Centers for Disease Control and Prevention (CDC), one out of three adults aren&rsquo;t getting screened for <a href="https://www.sharecare.com/health/cancer/quizzes/quiz-colon-health" target="_blank" title="Colon Health quiz">colon cancer</a> when they should.

When I heard this, I thought of my best friend.

Because of her family history&mdash;her mother had had colon cancer, and beat it&mdash;my friend knew she was at risk. Some&nbsp;<a href="https://www.sharecare.com/health/colon-cancer/history-colon-cancer-affect-screening" target="_blank" title="Colon Cancer history">guidelines</a>&nbsp;say most people should begin having colonoscopies at age 50, while others say 45, and possibly earlier if colon cancer runs in the family.

My friend knew all that. But with three young kids and a busy household to run&mdash;and besides, she had no <a href="https://www.sharecare.com/health/colon-cancer/what-signs-colon-cancer" target="_blank" title="Colon cancer symptoms">symptoms</a>&mdash;she put off the colonoscopy for a couple of years. By the time she got around to having it, the cancer had already spread to her liver. Six months later, my happy, fun-loving, always-in-control friend died. She was 47.

Heartbreaking? Yes. Especially because it didn&rsquo;t have to happen. According to the CDC, as many as 60 percent of all deaths from colon cancer could be prevented if everyone over age 50 got screened. And here&rsquo;s more good news about colonoscopies:

The prep is not as bad as you think. Having a colonoscopy once meant having to down a gallon of foul-tasting stuff the day before&mdash;and staying close to a bathroom afterward. Now there are other options, including split dosages and laxatives in pill form, that make the prep work easier to swallow.

They work. According to the American Society for Gastrointestinal Endoscopy, a study by major cancer groups found that deaths from colon cancer fell nearly 5% from 2002 to 2004, in large part because of screening tools, including colonoscopies.

Is it time to schedule yours? Do it today.

Medically reviewed in February 2020.

Have You Had Your Colonoscopy Today?

You might think of&nbsp;<a href="https://www.sharecare.com/health/colon-cancer/article/colorectal-cancer-what-you-need-to-know">colorectal cancer</a>&nbsp;as a condition that only affects older people. While it&rsquo;s true that the risk rises as you age, an increasing number of younger adults are developing the disease.

For adults under age 50, the rate of colorectal cancer diagnosis rose 2.2 percent each year from 2011 to 2016, according to a March 2020 report from the American Cancer Society (ACS). The rate also increased about 1 percent annually in Americans aged 50 to 64. At the same time, it dropped 3 percent each year for seniors.

But that&rsquo;s not all. The ACS report found that between 2008 and 2017, the colorectal cancer death rate for people under 50 increased 1.3 percent yearly. In those aged 50 and up, it decreased, due in part to more screening.

&ldquo;People can get colon cancer under 50,&rdquo; says Rya Kaplan, MD, a gastroenterologist with Trident Medical Center in Charleston, South Carolina. &ldquo;It&rsquo;s not the norm, but it can happen.&rdquo; That&#39;s part of the reason the ACS updated its screening guidelines in May 2018. The organization&nbsp;<a href="https://www.sharecare.com/health/gastrointestinal-health/article/colorectal-cancer-screenings-start">recommends beginning at age 45</a> for people of average risk, rather than age 50.&nbsp;In May 2021, the U.S. Preventive Services Task Force also lowered its recommended age to begin screening from 50 to 45.

Colorectal cancer is the fourth most common cancer in the U.S. and the third-leading cause of cancer death. That said, about 90 percent of people live five or more years if their colorectal cancer is found early.

Evidence for younger screening 
According to a February 2017 study in the Journal of the National Cancer Institute, while colorectal cancer has generally declined in people over the age of 55 since the 1970s and 80s, it has risen for people younger than 55. &ldquo;We are certainly seeing younger patients with colorectal cancer more frequently,&rdquo; says Keith Roach, MD, associate professor in clinical medicine in the division of general medicine at Weill Cornell Medical College and New York Presbyterian Hospital.

Another study, published in the journal Cancer in March 2016, found that of more than 258,000 people with colorectal cancer, about one in seven developed it before age 50. The ACS estimates that about 12 percent of new cases diagnosed in 2020 will occur in this age group.

Eating too much red meat and too little fiber might increase a person&#39;s risk of colorectal cancer, as can insufficient exercise and excess body weight. In fact, an October 2018 study published in JAMA Oncology linked obesity and weight gain in young adulthood to a higher <a href="https://www.sharecare.com/health/cancer-causes-and-risk-factors/article/obesity-cancer-what-link">colorectal cancer risk</a> in women under 50.

Current screening guidelines 
Without screening, most people under the age of 50 won&rsquo;t know they have colorectal cancer until symptoms show up, and by then it has probably already spread, says Dr. Kaplan. At later stages, younger people who undergo colorectal cancer surgery are more likely to get potentially debilitating <a href="https://www.sharecare.com/health/cancer-treatment/article/know-before-you-go-chemotherapy">chemotherapy</a> after the operation, but are no more likely to survive, according to a January 2017 study published in&nbsp;JAMA Surgery.

While guidelines now recommend that people at average risk for colon cancer start screening at age 45, those at a higher risk may need to start sooner. &ldquo;People with a family history&nbsp;of colon cancer or people with polyps will probably be screened earlier,&rdquo; says Kaplan.

They&#39;re not the only ones. &ldquo;Higher rates are seen in people of lower socioeconomic status, possibly due to lower physical activity, unhealthy diet, smoking, obesity and lower screening rates,&rdquo; says&nbsp;Julia Saylors, MD, a medical oncologist also with&nbsp;Trident Medical Center. And, African Americans have the highest rates of colorectal cancer of any ethnic group in the U.S. That could be partially due to genetic factors, but also because they&rsquo;re less likely to be screened, says Dr. Saylors.

The ACS says the most important thing is to get screened, no matter which test you choose, and there are several options.

<ul>
	<li><a href="https://www.sharecare.com/health/managing-your-health-care/slideshow/know-before-you-go-colonoscopy">Colonoscopies should be done</a> every 10 years.</li>
	<li>Fecal tests need to be repeated every one to three years, depending on the specific test used.</li>
	<li>CT colon scans and&nbsp;flexible sigmoidoscopies&nbsp;are done every five years.</li>
</ul>

What you can do 
If you have an increased risk of colorectal cancer or other types of cancer, talk to your healthcare provider (HCP) about when you should start screening. Also, be aware of&nbsp;colorectal cancer symptoms&nbsp;and see your HCP if you have:

<ul>
	<li>Blood in your stool</li>
	<li>Narrow stool</li>
	<li>Change in bowel habits</li>
	<li>Unexplained weight loss</li>
	<li>Fatigue or weakness</li>
	<li>Cramps or bloating&nbsp;</li>
</ul>

No matter your age, healthy habits can reduce your risk of colorectal cancer. These include:

<ul>
	<li>Eating a high-fiber, low-fat diet and limiting red and processed meat</li>
	<li>Drinking alcohol sparingly</li>
	<li>Maintaining a healthy weight</li>
	<li>Not smoking&nbsp;</li>
</ul>

Getting regular physical activity is also a good way to help lower your odds. In one 2016 meta-analysis in the British Journal of Sports Medicine, researchers found that the most physically fit individuals had a 19 percent lower risk of colorectal cancer than the least physically fit individuals. It&rsquo;s just another good reason to <a href="https://www.sharecare.com/health/fitness-exercise/slideshow/easy-tips-exercising-hate-working-out">get moving</a>.

Sources:

Stacy Simon. &ldquo;Colorectal Cancer Rates Rise in Younger Adults.&rdquo; American Cancer Society. March 5, 2020. 
Centers for Disease Control and Prevention. &ldquo;United States Cancer Statistics: Rate of New Cancers, Colon and Rectum, United States, 2016,&rdquo; &ldquo;Colorectal Cancer Statistics.&rdquo; 
RL Siegel, SA Fedewa, et al. &ldquo;Colorectal Cancer Incidence Patterns in the United States, 1974&ndash;2013.&rdquo; JNCI: Journal of the National Cancer Institute. Volume 109, Issue 8, August 2017. 
American Cancer Society. &ldquo;Colorectal Cancer Screening Guidelines,&rdquo; &ldquo;Survival Rates for Colorectal Cancer,&rdquo; &ldquo;Colorectal Cancer Signs and Symptoms,&rdquo; &ldquo;Six Ways to Lower Your Risk for Colorectal Cancer.&rdquo; 
J Wise. &ldquo;One in seven colorectal cancer patients is under 50, US study shows.&rdquo; BMJ. 2016; 352 :i414. 
P Liu, K Wu, et al. &ldquo;Association of Obesity With Risk of Early-Onset Colorectal Cancer Among Women.&rdquo; JAMA Oncology. 2019;5(1):37&ndash;44. 
Nicholas Bakalar. &ldquo;Obesity Tied to Colon Cancer Risk in Younger Women.&rdquo; New York Times. October 11, 2018. 
U.S. Preventive Services Task Force. &ldquo;Colorectal Cancer: Screening.&rdquo; 
L Liu, Y Shi, et al. &ldquo;Leisure time physical activity and cancer risk: evaluation of the WHO&#39;s recommendation based on 126 high-quality epidemiological studies.&rdquo; British Journal of Sports Medicine. 2016 Mar;50(6):372-8.

More People Under 65 Getting Colorectal Cancer, Says American Cancer Society

Research shows that a simple 60-second daily habit might help people of a certain age lower their risk of colon cancer. The quick trick? Popping a low-dose aspirin.

Although daily low-dose aspirin certainly isn&#39;t for everyone, new research suggests that middle-aged people on this kind of therapy may have as much as a 25 percent lower risk of colon cancer.

Ask before you leap 
In studies, daily low-dose aspirin also appeared to slash the likelihood of dying from colon cancer&mdash;by about 35 percent. And aspirin cut the risk of cancer in the proximal colon, where it&#39;s harder to detect, by a whopping 70 percent. But before you start popping, know this: Daily aspirin therapy is one of those habits that can lower the risk of some health conditions, like stroke or heart attack, but raise the threat of others, like ulcers or brain bleeds. And the benefits only apply to certain age groups. So no one should start daily low-dose aspirin therapy without first having an in-depth conversation with a doctor.

More good colon moves 
Research suggests that aspirin may help prevent colon cancer by hampering an enzyme that causes cancer-cell-supportive inflammation. But it&#39;s just one of many potential ways to help protect the colon from cancer. And even in small doses, aspirin makes it harder for blood to clot. So while you talk to your doctor about your options, consider these other colon-protective steps you could take:

<ul>
	<li>Don&#39;t die of embarrassment&mdash;get the screening that could save your life.</li>
	<li>Cut down on red meat.</li>
	<li><a href="https://www.sharecare.com/health/omega-3-fatty-acids/types-omega-three-fatty-acids">Take your Omega-3s.</a></li>
</ul>

<a href="https://www.sharecare.com/health/colon-cancer-diagnosis/what-tests-diagnose-colon-cancer">Find out about all of the tests that can help detect colon cancer.</a>

Rectal Cancer