Gastroenterologist Shares Who Should Get Early Screening For Colon Cancer

Previously, colon cancer screenings were recommended for people starting at the age of 50. However, these guidelines have since changed to a starting age of 45 in response to greater numbers of young people being diagnosed with colon cancer. "The exact reason why younger people have increasing rates of colon cancer is unclear," Dr. Joseph J. Jennings, gastroenterologist at MedStar Health, told Health Digest in an exclusive interview. "There are multiple factors being considered, but the exact mechanism is unknown," he says. "The major takeaway thus far is that the rate increased in this part of the population compared to decreasing rates in the older populations."

Dr. Jennings goes on to describe who is most at risk for colon cancer. "Time is the universal risk factor, which is why all people are recommended to start screening at age 45 even if they do not have any other risk factors," he states.

"Other risk factors include genetic abnormalities/syndromes where rates of colon cancer are markedly increased, inflammatory conditions of the colon like ulcerative colitis or Crohn's disease, or having a family history of colon cancer," Dr. Jennings further explains. "Family history is especially important when the relative with colon cancer is a first-degree relative to the patient and was diagnosed before the age of 60 (though all family history of colon cancer is important to share with your gastroenterologist)."

Dr. Jennings goes on to explain under what circumstances a colon cancer screening may be recommended even earlier than the age of 45.

Who should get screened before the age of 45

"Patients with a family history of colon cancer should start screening at age 40, or 10 years prior to the age when their family member was diagnosed," he explains. To determine the best timing, Dr. Jennings encourages patients to speak with a gastroenterologist.

"Patients with ulcerative colitis or Crohn's disease of the colon also are screened for colon cancer more often and at younger ages depending on when they were diagnosed with their inflammatory bowel disease," Dr. Jennings states. "Patients with known genetic conditions will also start screening at a much younger age and get screened more often — the specifics of this depending on their exact genetic condition."

Most importantly, Dr. Jennings emphasizes that no matter one's age, anyone experiencing potential symptoms of colon cancer should be evaluated by a gastroenterologist. However, he points out that an evaluation is different from a screening. "The main symptoms we think of when considering colon cancer include blood in the stool, changes in the patient's bowel habits such as harder to pass stool, bloating, abdominal pain, or unexpected weight loss," he says. 

Concluding the interview, Dr. Jennings states, "While there are many things that can cause those symptoms, and thankfully most are not colon cancer, in the appropriate context further testing (such as a colonoscopy) may be requested to help rule out colon cancer as a cause."