Colorectal Cancer Awareness Month: When should you start screening?

Colorectal cancer has gone through a rebranding campaign over the past few years thanks to awareness efforts not just during Colorectal Cancer Awareness Month, which takes place in March, but all year long.

These efforts have sought to reposition public thinking about cancers of the colon and rectum. While these conditions were once considered problems for older people, awareness of the risk for colorectal cancer in younger people is growing.

Stories like that of actor Chadwick Boseman, who died at 43, have shed light on the growing incidence of this diagnosis in people between the ages of 30 and 40. In fact, according to the National Cancer Institute, the rate of colorectal cancer has more than doubled in people under 50 since the 1990s, even as rates have dropped among older adults.

Colorectal cancer: 3 quick facts to know

1. Incidence

Each year, about 150,000 people are newly diagnosed with colorectal cancer, which makes the disease the third most common cancer in the United States.

2. Risk factors

While anyone can get colorectal cancer, certain factors can increase a person's risk. Some of these, such as lifestyle behaviors, can be controlled, while others can't. Risk factors for colorectal cancer include:

• Smoking and alcohol use
• Being overweight or obese
• Being sedentary without regular exercise
• Eating certain processed foods or red meats in excess
• Personal or family history of colon cancer or polyps
• Inflammatory bowel disease
• Certain genetic changes, such as Lynch syndrome
• Certain backgrounds, such as being an African American or an Ashkenazi Jew

3. Symptoms

Symptoms of colorectal cancer can resemble other common problems. Some signs of the condition include new changes in your bowel habits (like diarrhea or constipation), blood in the toilet bowl, pain in the stomach area and unexplained weight loss. If you have any of these concerns, don't hesitate to talk to your doctor.

However, not all colorectal cancers will cause symptoms early, which is why medical screening is the best early detection tool.

When and how often to get screened for colorectal cancer

According to current medical guidance, the latest age when a person should start screening for colorectal cancer through stool-based testing or visual exams is 45 years old. Sarah Cannon, the Cancer Institute of HCA Healthcare, recommends consulting your doctor if you are 45 or older to determine the right screening test for you. Evidence-based options may include:

• A colonoscopy every 10 years
• A fecal immunohistochemistry test (FIT) annually
• A FIT-DNA test (also known as the stool DNA test) every one to three years
• Flexible sigmoidoscopy every 5 years
• Flexible sigmoidoscopy every 10 years and annual FIT
• Other options your doctor may recommend

If you have close family members who have been diagnosed with colorectal or adenomatous polyps at an early age, you may need to have regular colonoscopies starting either at age 40 or when you're 10 years younger than your relative was when they were diagnosed. For example, if your parent had polyps detected at 45, your screening age might be 35.

However, these recommendations can be complicated and may vary widely based on your situation. Check with your primary care doctor to determine what would be best for you so you can get timely and medically appropriate screenings as well as any genetic testing you might need to watch for colorectal and other cancers.

Prevention guidance to keep in mind

Many cancers are closely associated with lifestyles and behaviors like diet and exercise, but the links between unhealthy habits and colorectal cancer specifically are quite strong. In fact, one theory about why the incidence of colorectal cancer is up among young people is lifestyle-related: American diets and fitness levels have increasingly become unhealthy over the past several decades.

Because your risk for colorectal cancer goes up with age, you can help create cancer-prevention habits early with a few simple changes, such as eating a balanced diet, getting more physical activity and quitting smoking if you're a smoker.

These tips may not eliminate your risk, but they could help lower it, and someday, that could make all the difference.