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Screening for Colorectal Cancer Starts at 45

Image of Heather Saxby, FNP-BC, Mansilla Medical
Heather Saxby, FNP-BC, Mansilla Medical

Early detection is the key to preventing and treating colorectal cancer. A potentially game-changing new recommendation from The U.S. Preventive Services Task Force (USPSTF) could save lives in the fight against colorectal cancer, the third-leading cause of cancer deaths in the United States. Currently, screening for colorectal cancer is recommended to begin at age 50; however, the USPSTF is now urging routine screening to begin five years earlier, starting at age 45. This recommendation is consistent with the American Cancer Society’s recommendation in 2018 and applies to individuals even without a prior personal or family history or colorectal cancer, precancerous polyps or inflammatory bowel disease.

mansilla colorectal cancer


Younger onset of colorectal cancers are on the rise, increasing 2% each year for individuals under age 55, according to the Colorectal Cancer Alliance; with ages 20 to 54 years old representing one in five colorectal cancer patients, per The Colon Cancer Coalition. New guidance further stressed the importance of screening especially for African Americans, who have the highest rates of colorectal cancer incidence and deaths. The American Association for Cancer Research found in 2019 that many younger patients were disproportionately initially misdiagnosed and referred to multiple providers before a diagnosis was made.

Tests recommended by the taskforce are often covered by Medicare, Medicaid, and private insurance, thus improving access to valuable preventive screening programs. Colonoscopies are often considered the gold standard for colorectal screening, however the recommendation for earlier screening also includes high-sensitivity stool-based tests; noting that reluctance to obtain a colonoscopy should not be a barrier to screening. Individuals are encouraged to discuss the testing options with his or her primary care provider and mutually decide the best testing method; “...the right test is the one that gets done," stated Martha Kubik, USPSTF taskforce member.


Increased screening may detect and even prevent colorectal cancers from forming when polyps (growths that may be precancerous) are identified and removed during screening. Identifying colorectal cancer at an earlier stage has the most significant impact on survivability, as the 5-year survival rate is 90% for those diagnosed with localized-stage disease, per; this number significantly declines with later disease staging.


The USPSTF is an non-government affiliated, independent panel of volunteer national experts, working to enhance disease prevention and make recommendations to promote public health based on the latest evidence. Their recommendation was published on May 18, 2021 and based on a systematic review of scholarly research from MEDLINE, PubMed, and the Cochrane Review to address the efficacy, accuracy, and potential harms of screening.