March is Colon Cancer Awareness Month
What You Need to Know About Screening, Risk, and Prevention
Colon cancer (also called colorectal cancer) was once thought of as a disease affecting primarily older adults, but that is changing. Over the past decade, rates have been steadily increasing in younger individuals, and many people diagnosed before age 50 have no obvious risk factors or early symptoms.
The encouraging news? Colon cancer is one of the most preventable and treatable cancers when detected early.
Screening allows us to find and remove precancerous polyps before they turn into cancer and when cancer is caught early, outcomes are significantly better.
Why We’re Talking About Colon Cancer Earlier
There has been a noticeable rise in colon cancer among adults under 50 years of age. Because of this, screening guidelines have shifted to start earlier than in the past.
And this matters.
Patients whose colon cancer is found through screening have significantly lower mortality (by ~50–65%) compared to those diagnosed after symptoms appear.
Screening doesn’t just detect cancer, it saves lives.
When Should Screening Start?
Average-risk adults:
- Begin screening at age 45
Higher-risk adults:
- May need screening before age 45
- Often require colonoscopy (not stool tests)
- May need more frequent screening
If you’re unsure where you fall, reviewing your personal and family history with your physician is the best first step.
What Does “Higher Risk” Mean?
You may be considered higher risk if you have:
Personal history of:
- Colon polyps
- Colon cancer
- Inflammatory bowel disease (Crohn’s or ulcerative colitis)
Family history of:
- Colon cancer (especially a first-degree relative)
- Advanced polyps
- Genetic syndromes (like Lynch syndrome)
Other risk factors:
- Type 2 diabetes
- Obesity
- Smoking
- Heavy alcohol use
- Diet high in processed/red meats and low in fiber
Higher-risk patients should typically go straight to colonoscopy.
Screening Options for Colon Cancer
There is no one-size-fits-all test. The best screening test is the one that is appropriate for your risk level and completed consistently.
Colonoscopy
Frequency: Every 10 years (if normal, average risk)
What it does:
- Examines the entire colon
- Removes polyps during the same procedure
- Prevents cancer through polyp removal, not just detects it
Best for:
- Higher-risk individuals
- Anyone with symptoms
- Those wanting the most comprehensive evaluation
FIT Test (Fecal Immunochemical Test)
Frequency: Every year
What it does:
- Detects microscopic blood in stool
- Done at home
- No prep or sedation
Best for:
- Average-risk adults
- Those wanting a noninvasive option
A positive FIT test requires a follow-up colonoscopy.
Cologuard (Stool DNA Test)
Frequency: Every 3 years
What it does:
- Detects blood and DNA markers
- Completed at home
Best for:
- Average-risk adults age 45+
- Those who prefer to avoid colonoscopy
Not recommended for:
- Higher-risk individuals
- Prior polyps or colon cancer
- Inflammatory bowel disease
- Symptoms
A positive result requires a colonoscopy.
Who Should Go Straight to Colonoscopy?
Skip stool-based testing if you have:
- Rectal bleeding
- Iron deficiency anemia
- Persistent change in bowel habits
- Unexplained weight loss
- Ongoing abdominal pain
- Family history of colon cancer
- Personal history of polyps
- Inflammatory bowel disease
- Positive FIT or Cologuard
Stool tests are for screening when you feel well—not for evaluating symptoms.
Signs and Symptoms of Colon Cancer
Colon cancer often develops silently, which is why screening matters.
Possible warning signs:
- Blood in stool
- Persistent bowel changes
- Narrow stools
- Unexplained weight loss
- Fatigue or anemia
- Abdominal discomfort or bloating
If you notice any of these, it’s important to seek evaluation promptly.
What Increases Risk?
Risk is influenced by both genetics and lifestyle:
- Smoking
- Excess alcohol use
- Obesity
- Sedentary lifestyle
- Diet high in processed/red meats
- Low fiber intake
- Type 2 diabetes
- Family history
What Lowers Risk?
There are meaningful ways to reduce your risk:
- Regular physical activity
- High-fiber diet (vegetables, fruits, legumes, whole grains)
- Maintaining a healthy weight
- Limiting processed/red meats
- Limiting alcohol
- Not smoking
- Staying up to date with screening
Screening remains one of the most powerful tools because it can prevent cancer, not just detect it.
The Bottom Line
- Colon cancer is rising in younger adults
- Screening starts at age 45 for average risk
- Earlier screening is needed for higher-risk individuals
- Multiple options exist: colonoscopy, FIT, and Cologuard
- The best test is the one completed consistently
- Early detection significantly lowers mortality
A Note from Dr. Williams-Drueding
If you’re unsure which screening option is right for you or if you’ve been putting it off, you’re not alone. These decisions are often easier when they’re personalized.
At Active Health DPC, we take the time to review your history, risk factors, and preferences so screening feels clear, approachable, and manageable.
Prevention and early detection truly save lives.
