Colon Cancer Screening: Life-Saving Tests You May Be Skipping

Colorectal cancer is the second leading cause of cancer death in the United States — and one of the most preventable. When caught at stage I, the 5-year survival rate is 91%. When diagnosed at stage IV (with spread), it drops to 13%. The difference is almost entirely screening.

When to start screening: The American Cancer Society recommends colorectal cancer screening beginning at age 45 for average-risk adults — reduced from 50 in 2021 due to rising rates in younger adults. Those with a family history of colorectal cancer or polyps should begin at 40, or 10 years before the youngest affected relative, whichever comes first.

Screening options: Colonoscopy is the gold standard — it allows direct visualization of the entire colon and removal of precancerous polyps in the same procedure. A normal colonoscopy does not need to be repeated for 10 years. Cologuard stool DNA test is a non-invasive alternative performed every 3 years. A positive Cologuard requires follow-up colonoscopy.

The colonoscopy prep is easier than ever: Modern split-dose preparations are much more tolerable than older full-gallon prep solutions. Low-volume options (like SUFLAVE or PLENVU) require drinking just 1 liter. The procedure itself is performed under sedation — most patients have no memory of it and resume normal activity the same afternoon.

What happens if polyps are found: Most polyps are benign and are simply removed during the colonoscopy. Adenomatous polyps are precancerous — their removal is what makes colonoscopy such an effective cancer prevention tool, reducing colorectal cancer mortality by 60–70%.

Rising rates in younger adults: Colorectal cancer rates have increased 51% among adults under 50 since 1994. See your doctor promptly if you experience: rectal bleeding or blood in stool, a persistent change in bowel habits, unexplained abdominal pain or cramping, unexplained weight loss, or a feeling that the bowel does not fully empty.

Dr. Anthony Carter provides colonoscopy and colorectal cancer screening at SilverOak University Medical Center, Detroit. He also offers video consultations to discuss screening options, bowel symptoms, or family history assessment.