Colorectal cancer is one of the most common cancers in the United States, but screening can help find colorectal cancer early and can also identify polyps before they become cancerous. Several screening options are available, including tests that can be completed at home and exams performed by a healthcare professional.
For adults over 65, the right screening plan depends on factors such as age, overall health, previous screening history, and personal risk factors. Understanding your options can help you have a more informed conversation with your healthcare provider.
For adults at average risk, the U.S. Preventive Services Task Force (USPSTF) recommends regular colorectal cancer screening from ages 45 through 75. For adults ages 76 to 85, the decision to continue screening should be individualized based on overall health, prior screening history, and personal preferences.
The American Cancer Society similarly recommends regular screening through age 75 for people in good health with a life expectancy of more than 10 years. For adults ages 76 to 85, it recommends discussing screening with a healthcare provider. People over 85 generally should no longer receive colorectal cancer screening.
These recommendations apply to adults at average risk. You may need a different screening schedule if you have a personal or family history of colorectal cancer or polyps, inflammatory bowel disease, or certain inherited conditions.
There isn’t just one way to screen for colorectal cancer. Common options include:
FIT: A fecal immunochemical test looks for hidden blood in a stool sample and is generally completed at home once a year.
Stool DNA-FIT: This at-home test checks a stool sample for blood and certain DNA changes associated with colorectal cancer. It is generally completed every three years.
Colonoscopy: A healthcare professional uses a flexible, lighted tube to examine the entire colon and rectum. Polyps can often be removed during the procedure. For adults at average risk, colonoscopy is generally performed every 10 years when results are normal.
CT colonography: Sometimes called a virtual colonoscopy, this imaging test uses X-rays to create images of the colon and rectum. It is generally performed every five years.
The best option depends on your health, preferences, previous screening, and discussions with your healthcare provider.
One important point: If a stool-based test or another non-colonoscopy screening test produces an abnormal result, a follow-up colonoscopy is generally needed.
The preparation depends on the screening method you choose.
For an at-home stool test, your healthcare provider or testing program will provide instructions for collecting and returning your sample. These tests do not require the bowel preparation or sedation associated with a colonoscopy.
A colonoscopy requires preparation to clean the colon beforehand. Your healthcare team will give you specific instructions about what to eat and drink, when to stop eating or drinking, and how to take the prescribed bowel preparation. Sedation is commonly used during the procedure.
If you’re concerned about the preparation, discomfort, sedation, or what happens if a polyp is found, ask your healthcare provider what to expect before scheduling your screening.
Your next appointment can be a good opportunity to discuss your colorectal cancer screening plan. Consider asking:
If you’ve never been screened or are unsure when you were last screened, let your healthcare provider know. Your screening history can help determine what comes next.
Screening is intended to find colorectal cancer or precancerous changes before symptoms develop. That’s why staying up to date with recommended screening can be important even if you feel healthy.
Symptoms such as blood in the stool, unexplained changes in bowel habits, unexplained weight loss, persistent abdominal discomfort, or unusual fatigue should be discussed with a healthcare professional. Symptoms may require diagnostic evaluation rather than routine screening.
Colorectal cancer screening doesn’t have to be complicated. There are multiple options, and your healthcare provider can help you determine which approach makes sense based on your age, health, screening history, and risk factors.
If you’re 65 or older, ask whether you’re up to date with colorectal cancer screening and whether it’s time to review your options.
Champion Health Plan is here to help you stay informed about preventive care. Talk with your healthcare provider about colorectal cancer screening and the option that may be appropriate for you.
This article is for educational purposes only and is not a substitute for medical advice, diagnosis, or treatment. Screening recommendations can vary based on individual health history and risk factors. Talk with your healthcare provider about the screening schedule that’s right for you.
