For decades, the standard advice was to begin colorectal cancer screening at age 50. That guidance has changed. Leading organizations, including the American Cancer Society and the U.S. Preventive Services Task Force, now recommend that people at average risk begin screening at age 45.
If you are between 45 and 50 and have not yet been screened, you are now due. Here is why the recommendation changed and what it means for you.
Why the age was lowered
The change was driven by a clear and troubling trend: colorectal cancer has been rising among younger adults. While overall rates have declined in older populations, largely thanks to screening, diagnoses in people under 50 have been climbing steadily for years.
Lowering the starting age to 45 is intended to catch these cancers earlier, when they are far more treatable, and to find and remove precancerous polyps before they ever become cancer.
The guideline changed because the disease changed. More people in their forties are being diagnosed than in the past, and screening earlier saves lives.
Who should start even earlier
Age 45 applies to people at average risk. You may need to begin screening before 45 if you have:
- A family history of colorectal cancer or advanced polyps
- A personal history of polyps or inflammatory bowel disease, such as Crohn's disease or ulcerative colitis
- A known hereditary condition such as Lynch syndrome or familial adenomatous polyposis
- Symptoms such as rectal bleeding, a change in bowel habits, or unexplained weight loss, at any age
Your physician can help determine the right starting age and screening interval based on your personal and family history.
What screening at 45 involves
Colonoscopy remains the most thorough screening option because it examines the entire colon and allows any polyps found to be removed during the same procedure. Other screening methods exist, including stool-based tests, but a positive result on any of those still requires a follow-up colonoscopy.
For most people at average risk, a normal colonoscopy at 45 means the next one is not due for ten years.
The takeaway
If you have turned 45, colorectal cancer screening is now part of your routine preventive care, just like other age-appropriate screenings. It is one of the few tests that can actually prevent cancer rather than simply detect it. Talk with your physician about getting started.
Has the recommended age for colonoscopy really changed?
Why was the screening age lowered to 45?
Should anyone start colonoscopy screening before 45?
If my colonoscopy at 45 is normal, when is the next one?
This article is for general educational purposes and is not medical advice. For guidance specific to your health, history, and risk factors, please consult a physician.