Since 2021, colorectal cancer screening has been recommended starting at age 45. But a new study shows that many people in their 40s still aren’t hearing about it from their doctors.
Researchers at the American Cancer Society (ACS) studied answers from a 2024 national survey and shared their findings in the Journal of General Internal Medicine. Among adults ages 45 to 49:
- Only about half said a doctor or other health care provider had ever told them there are different ways to get screened. For people ages 65 to 75, it was nearly 3 in 4.
- Nearly 1 in 4 said they had never talked about screening tests with a doctor or provider at all.
- About 1 in 3 Black adults had been told about different screening options, while nearly twice as many White adults the same age had.
- People without health insurance were about half as likely as those with insurance to have been told about their options.
Why this matters
Colorectal cancer is rising in younger adults, and fewer than 4 in 10 people ages 45 to 49 are up to date on screening. People are much more likely to get screened when their doctor brings it up. The researchers say it can take time for new guidelines to reach doctors’ offices, and they’re calling for better training for doctors and outreach that reaches everyone.
Jordan Baeker Bispo, PhD, MPH, Principal Scientist for Cancer Disparity Research at ACS, led the study. We asked Dr. Baeker Bispo what she would ask of doctors and health systems based on these findings.
“There is a huge opportunity to increase screening in younger adults through improved communication in the clinical setting. People are more likely to get screened if they know their options. By sharing information about different screening tests, doctors empower their patients to choose the test that works best for them. This work is critical for efforts to reduce the growing burden of early-onset colorectal cancer in the US.”
-Jordan Baeker Bispo, PhD, MPH
Rebecca Siegel, MPH, Senior Scientific Director of Surveillance Research at ACS, shared these findings with us. Rebecca serves on Fight CRC’s Medical Advisory Board and is a member of our Early-Age Onset Colorectal Cancer (EOCRC) Global Research Collaborative. We asked Rebecca the same question.
“Guideline changes only matter if they reach the exam room. Adults in their 40s are busy building careers and families, and many would gladly do an at-home stool test but haven’t been told it’s an option. Health systems can save lives with electronic record prompts and mailed stool tests for everyone 45 and older, with particular emphasis on Black patients and those without insurance.”
-Rebecca Siegel, MPH
What you can do
- Don’t wait for your doctor to bring it up. If you’re 45 or older, ask about screening at your next visit.
- Know your family history. If a parent, brother, sister, or child has had colorectal cancer or certain polyps, you may need to start screening before 45. Don’t wait until 45 to ask your doctor when you should start.
- Know your options. There’s more than one way to get screened, including colonoscopy and at-home stool tests. Ask your doctor which one is right for you. [LINK: Fight CRC screening resources]
- Listen to your body. Screening is for people without symptoms. If you have symptoms at any age, talk to a doctor right away.
How Fight CRC is working on this
Gaps like this one are why we bring patients, doctors and researchers together. Through our Global EOCRC Think Tank and Global Research Collaborative, we work with partners like Rebecca to turn findings into action, so every person ages 45 and up hears about screening, no matter their race, insurance, or zip code. [LINK: EOCRC Think Tank] [LINK: Global Research Collaborative]
Source: Baeker Bispo J, Bandi P, Jemal A, Islami F. Age-Related Differences in Clinician Communication About Colorectal Cancer Screening in the USA. J Gen Intern Med. 2026. doi:10.1007/s11606-026-10854-0