New colorectal cancer screening guidelines issued

March 1, 2021

Adults 45 and older should be screened

Americans’ chance of surviving colorectal cancer are better today than 20 years ago, primarily due to increased screening adoption and better screening tests. While the incidence of colorectal cancer has steadily decreased for those 50 to 75 years old, a recent increase in new cases for individuals under 50 years of age has prompted both the American Cancer Society and the U.S. Preventive Services Taskforce (USPSTF) to recommend screening for colorectal cancer to begin at 45 years of age.

The American Cancer Society reports that from 2007 to 2016, colorectal cancer incidence (CRC) decreased by 3.6% per year among adults aged 55 years and older, but increased by 2% per year in adults younger than 55 years. From 2008 to 2017, mortality from CRC decreased by 2.6% per year among adults aged 55 years and older, but increased by 1% per year among adults younger than 55 years*.

The USPSTF issued a draft recommendation last October to screen people of average risk who are between 45 and 49 years of age. The recommendation is based on a commissioned review** of the current evidence from CISNET Colorectal Cancer Working Group to determine three things: the effectiveness of colorectal cancer screening to prevent or reduce death from colorectal cancer in adults age 40 and older, the accuracy of various screening tests to detect colorectal cancer and non-cancerous tumors and polyps, and whether screening individuals 40 and older would cause serious harm.

As with any recommendation, consult your health care provider for advice on how the recommendation applies to your health specifically.

The USPSTF draft recommendations:

  • Screen for colorectal cancer in adults 45-75 years.
  • Adults who are 76-85 years should speak with their clinician about the benefit of screening.
  • Adults with a personal history of colorectal cancer, polyps, or those with a personal or family history of disorders that increase the risk for colorectal cancer should consult with their clinician on best screening recommendations.

Understand your risk for colon cancer

Knowing your risks for colon and rectal cancer in addition to recommended screening will help avoid getting colorectal cancer. The following are risk factors according to the Centers for Disease Control for colorectal cancer.

Risk Factors for colorectal cancer:

  • Increasing age (90% of cases are people 50 years and older)
  • A history of colorectal polyps or colorectal cancer
  • Inflammatory bowel disease, Crohn’s disease, or ulcerative colitis
  • Genetic syndromes such as familial adenomatous polyposis (FAP) or hereditary non-polyposis colorectal cancer, also known as Lynch syndrome

Lifestyle factors that may increase your risk of colorectal cancer:

  • being overweight/obese
  • smoking
  • heavy drinking
  • Inactivity
  • Eating a lot of red/processed meats

Managing risk factors and appropriate screening based on your health can reduce your risk of getting colorectal cancer.

If you do not have a primary care physician, consider MSU Health Care for your provider. Visit our primary care page for more information on our practices and how to become a patient. MSU Health Care Gastroenterology is available for screening colonoscopies learn more on their page.


* American Cancer Society: Cancer Facts and Figures 2020. Atlanta, Ga: American Cancer Society, 2020. Available online.

**Lin JS, Perdue LA, Henrikson NB, Bean SI, Blasi PR. Screening for Colorectal Cancer: An Evidence Update for the U.S. Preventive Services Task Force. Evidence Synthesis No. 202. AHRQ Publication No. 20-05271-EF-1. Rockville, MD: Agency for Healthcare Research and Quality; 2020.