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Guidelines for Colorectal Cancer Screening

Here the signs and symptoms of colorectal cancer and the American Cancer Society’s guidelines on preventive screenings.

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A rise in rates of colorectal cancer among young and middle-aged adults has spurred the American Cancer Society to change its guidelines for when people should start screening for the disease.

The American Cancer Society (ACS) now recommends that people at average risk for colorectal cancer begin screening at age 45, five years earlier than the previous recommendation of 50. People who are at increased risk for the cancer may want to start colorectal cancer screening before age 45 or be screened more often.

Related: New Colon and Rectal Cancer Screening Guidelines

What prompted the change?

A study led by the ACS and published earlier this year found that, overall, rates of new colorectal cancer cases in the U.S. have been dropping since the mid-1980s. The decline has been even steeper during the past decade—for which the ACS credits screening tests. Some screening tests such as colonoscopies can find and remove suspicious growths before they have a chance to become cancer.

However, the decline in rates of newly diagnosed cases of colorectal cancer has been led by older adults. Incidence rates have actually been rising for adults younger than 50.In addition, the ACS study found that people younger than 55 are more likely than older people to be diagnosed with late-stage colorectal cancer. The study's authors theorized that younger people are delaying diagnosis because they don't recognize symptoms of the disease.

  • According to the ACS, the most common signs and symptoms of colorectal cancer include:
  • A change in bowel habits—such as diarrhea, constipation, or narrowing of the stool—that lasts for more than a few days
  • A feeling like you need to have a bowel movement that isn't relieved when you do have one
  • Rectal bleeding
  • Dark stools or blood in the stool
  • Cramping or abdominal pain
  • Weakness and fatigue
  • Weight loss for no known reason

Check your plan

There are multiple screening tests available for colorectal cancer, including noninvasive stool tests. The new guidelines from the ACS don't endorse a particular test, but they do stress regular screening and they recommend a follow-up with a colonoscopy if the results from another test are suspicious.

The new ACS guidelines don't quite match up with those of the U.S. Preventive Services Task Force, which still recommends screening for colorectal cancer at age 50. SelectHealth covers colorectal cancer screenings for members age 50 years and older at normal risk, and younger than 50 for those at high risk.

If you have a higher risk of colon cancer (i.e., if you have a family member who was diagnosed with colon cancer at age 45 or younger), we encourage you to discuss the timing of screening with your doctor.

While you’re here, check out our other articles on healthy living. Find information about our medical and dental plans by visiting selecthealth.org/plans.

The information that is contained here does not guarantee benefits. If you have any questions about your benefits or need to confirm your benefits, call Member Services at 800-538-5038.

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