Colorectal cancer screening begins at 45 for most Americans, but your family’s cancer history can play a huge role in when you should start screening.
Colon (or colorectal) cancer is cancer of the lower digestive tract, the part of the digestive system often referred to as the large intestine. It is the third most commonly diagnosed cancer for men and women in the United States. While there are currently 1.5 million colorectal cancer survivors living in the United States today, this disease is still the number two cancer killer for both men and women, behind only lung cancer.
Colorectal cancer most often begins as small polyps (benign growths similar to skin tags) in the lining of the large intestine or rectum. Over time, these growths can change and become cancerous. A colonoscopy can find and remove these growths before they become cancer, preventing cancer before it starts. Screening may also find early-stage cancer when the cancer is easiest to treat.
In 2021, the United States Preventative Task Force lowered the age for average-risk colorectal cancer screening from 50 to 45 years old. This means that those at average risk, with no family history and no symptoms, should now begin screening at 45. Approximately 25% of all colorectal cancer patients, however, have a family history, and about 5% of patients have an inherited genetic condition. Having a family history of colorectal cancer as well as certain types of polyps increases the risk for developing colorectal cancer.
Asking important questions
Learning the family’s health history is important to making informed decisions about health and when to start colorectal cancer screenings.
To learn your family history, start the conversation with some simple questions, and be patient when talking to older generations who may feel uncomfortable or embarrassed talking about digestive health and cancer.
A family member with colon cancer will increase your risk for colon cancer, and a long history of colon cancer as well as many different types of cancer in your family could indicate an inherited genetic condition, such as Lynch syndrome. So, ask your family, “Has anyone in our family had colon, rectal, or other types of cancer?”
In addition, a first-degree relative, such as a parent, a sibling, or a child, with certain types of polyps will also contribute to an increased risk for colorectal cancer. Start asking your family, “Have you had a colonoscopy?” and “Did you have any precancerous polyps (or adenomas) removed?”
When there is a family history of colorectal cancer or polyps, screening should begin earlier than age 45, ideally 10 years younger than the family member was when they were diagnosed.
Options for colorectal cancer screening
There are several screening options available for average risk people: non-invasive stool-based screening that can be done in the privacy of your home, virtual colonoscopies, and even blood tests. For those with a family history of colorectal cancer, however, screening means having a colonoscopy.
A colonoscopy is a thorough visual screening that can prevent cancer before it starts. The screening includes examining the entire colon and rectum. During the colonoscopy, a patient is sedated while a gastroenterologist looks at the inside of the rectum and colon, identifying and removing polyps, stopping potential cancer before it starts.
When a colonoscopy is complete, share the results with your family. Individual polyp history impacts an entire family’s screening options and timeline. Precancerous polyps and early-stage colon cancer often won’t produce warning signs or symptoms, so staying on top of family health history plays a huge role in the health of a family.
Colon cancer is a highly preventable and treatable disease. Knowing and understanding the family health history of colorectal cancer and polyps, then following a doctor’s recommendations for completing on-time colon cancer screenings, can save a life.