Colorectal Cancer Screening If you have a colon (and you do!), talk to your doctor about colorectal cancer screening. It can save your life. While over 90% of colon and rectal cancers are found in people over age 50, anyone at any age can get colorectal cancer. Take the quiz below to determine your risk factors for colorectal cancer and get important information on how to reduce your risk. Take our screening quiz Colorectal Cancer Screening Jump to... Who Should Get Screened? Screening Options Screening Resources Polyps Results Barriers to Screening Share on Facebook Share on LinkedIn Share on Twitter Copy this URL Share via Email Why Should I Get Screened for Colorectal Cancer? If you have a colon (and you do!), talk to your doctor about colorectal cancer screening. Colorectal cancer screening can save your life. While over 90% of colon and rectal cancers are found in people over age 50, anyone at any age can get colorectal cancer. All adults should talk to their doctor about when to start screening for polyps and cancer. The general population should begin screening at age 45. Those with a family history of colorectal cancer or precancerous colorectal polyps may need to begin screening before age 45, and anyone experiencing signs and symptoms of colorectal cancer (at any age) should have their symptoms evaluated. Screening should follow regular intervals through age 75 (the interval depends on which screening method is used), and people over 75 should talk to their doctor about whether screening is necessary. About Screening Should I Get Screened? Colorectal cancer is the second leading cause of cancer death in the United States, but early detection and prevention can save lives. This quiz will help you determine your risk factors for colorectal cancer and provide you with important information on how to reduce your risk. Other Reasons for Screening If you're under the recommended screening age of 45, your doctor may recommend a diagnostic colonoscopy if you are experiencing certain symptoms, such as: Abdominal pain, gas or bloating Changes in how often you have a bowel movement Poop that’s consistently not a normal stool color or has an unusual appearance Recurrent diarrhea Recurrent constipation Blood in the toilet, on the toilet tissue or in your poop Frequent indigestion Unexplained weight loss Malnutrition Chronic fatigue learn more about these symptoms If your doctor recommends a colonoscopy, it’s because they want to look at the inside of your colon for visual signs of what could be causing your symptoms, and take a tissue sample – which is called a colon biopsy – if needed. If you’ve had polyps or abnormal tissues identified by a previous colonoscopy, a follow-up colonoscopy may be recommended to look for or remove more polyps. Or if an at-home stool test for colorectal cancer screening came back positive, a colonoscopy would be the recommended next step. How Is The Screening Age Decided? Multiple professional organizations publish guidelines on colorectal cancer screening, including the US Preventive Services Task Force (USPSTF), United States Multi-Society Task Force (US-MSTF), the National Comprehensive Cancer Network (NCCN), the American Cancer Society (ACS), and the American College of Physicians (ACP). These guidelines are formed after an extensive review of research data. Under the Affordable Care Act (ACA), any USPSTF guideline that has a grade “A” or grade “B” designation is mandated to be covered by insurance companies without any cost-sharing to the patient.The USPSTF reviews (and if necessary, updates) guidelines every five years. read more about screening guidelines What Are My Screening Options? Colonoscopy WHAT IT IS? A medical procedure that allows a doctor to visually examine your entire colon and rectum to look for precancerous polyps. The patient is sedated and bowel prep is required. A colonoscopy is often considered the “gold standard” for colon screening because it can identify polyps and remove them during the same procedure. Visit our colonoscopy page for more in-depth information. In order for a colonoscopy to be effective, you first have to prep. Learn about all of your prep options on our colonoscopy prep page. HOW MUCH DOES IT COST? Varies by insurance, however for those eligible for screening based on the USPSTF screening guidelines, screening tests must be covered with no cost sharing to the patient. If you’re considering skipping or postponing screening because you don’t have insurance or the funding, think again. There are ways to get a free or low-cost colonoscopy. CDC’s CRCCP program: If you’re age 45 and over, check the Center for Disease Control and Prevention’s Colorectal Cancer Control Program (CRCCP) to see if you’re eligible for free screening from a grantee near you. You will need to contact the specific awardee directly to see what options are available. Colonoscopy Assist: A colon cancer screening program designed to remove financial barriers to colorectal cancer screening for the uninsured. Local Health Departments: Call your local health department and ask if there’s a state-funded colorectal cancer screening program near you. Primary Care Physician Referrals: Ask your PCP if they know of a gastroenterologist who provides services to underinsured or uninsured. During March, Colorectal Cancer Awareness Month, many health care providers offer reduced-cost or free colonoscopies. WHEN SHOULD IT BE REPEATED? Every 10 years, if normal. WHERE IS IT PERFORMED? Outpatient surgical center or hospital. THINGS TO CONSIDER Complications are rare but can include bleeding, infection, and bowel-wall injury. WHO IS A GOOD CANDIDATE? Most people are good candidates. This test is among the best ways to find and remove polyps early. Stool Test: FIT(Fecal Immunochemical Test) WHAT IT IS? Stool is collected at home and sent to a lab, which looks for small amounts of blood. You will be given instructions about how to use the kit at home, and where to send it when completed. One stool sample is needed. You will not have to touch the stool (but do a thorough hand-washing once you’ve collected the sample). There are no drug or dietary restrictions to take the test. HOW MUCH DOES IT COST? Screening tests must be covered by insurance. Coverage for a follow-up colonoscopy, if needed due to a positive test result, should also be covered by insurance. WHEN SHOULD IT BE REPEATED? Every year, if normal. WHERE IS IT PERFORMED? The patient’s home. THINGS TO CONSIDER It can’t detect or remove polyps. If you receive a positive test result, a follow-up colonoscopy is required. WHO IS A GOOD CANDIDATE? Great option for people hesitant to have a colonoscopy, but it must be performed every year. Stool Test: FIT-DNA/mt-sDNA (i.e. Cologuard®) WHAT IT IS? Stool is collected at home and sent to a lab, which looks for small amounts of blood or DNA markers associated with colorectal cancer. You will be given instructions about how to use the stool DNA kit at home, and where to send it when completed. One stool sample is needed. You will not have to touch the stool (but do a thorough hand-washing once you’ve collected the sample). HOW MUCH DOES IT COST? Screening tests must be covered by insurance. Coverage for follow-up colonoscopy, if needed due to a positive test result, should also be covered by insurance. WHEN SHOULD IT BE REPEATED? Every three years, if normal. WHERE IS IT PERFORMED? The patient’s home. THINGS TO CONSIDER It can’t detect or remove polyps. If you receive a positive test result, a follow-up colonoscopy is required. WHO IS A GOOD CANDIDATE? Great option for people hesitant about a colonoscopy, but it must be performed every three years. Stool Test: gFOBT WHAT IT IS? Stool is collected at home and sent to a lab, which looks for small amounts of blood. You will be given instructions about how to use the kit at home, which medications and foods to avoid (such as nonsteroidal anti-inflammatory drugs [NSAID] like ibuprofen and others) and where to send it when completed. Three stool samples are needed. You will not have to touch the stool (but do a thorough hand-washing once you’ve collected the sample). This test is no longer commonly used and has been mostly replaced by FIT. HOW MUCH DOES IT COST? Generally inexpensive. You can purchase this test over the counter without a prescription. WHEN SHOULD IT BE REPEATED? Every year, if normal. WHERE IS IT PERFORMED? The patient’s home. THINGS TO CONSIDER It can’t detect or remove polyps. If you receive a positive test result, a follow-up colonoscopy is required. Requires restrictions on certain drugs and food prior to taking the test. WHO IS A GOOD CANDIDATE? Great option for people hesitant about a colonoscopy, but it must be performed every year. CT Colonography WHAT IT IS? A noninvasive, advanced CT scan of the colon and rectum that produces two- and three-dimensional images of the colon and rectum, allowing the doctor to look for polyps or cancer within the images. The entire colon must be cleaned out for this procedure, just like a traditional colonoscopy. If abnormalities are found, your doctor will talk to you about the appropriate diagnostic procedure moving forward. Not everyone is a candidate for CT colonography, so be sure to talk to your doctor about this screening option. HOW MUCH DOES IT COST? Should be covered by insurance, but you may want to discuss with your insurance provider before undergoing this screening exam. WHEN SHOULD IT BE REPEATED? Every five years. WHERE IS IT PERFORMED? Hospital, clinic, or outpatient imaging center. THINGS TO CONSIDER If any abnormalities are found, such as polyps, a follow-up colonoscopy is required. WHO IS A GOOD CANDIDATE? People who aren’t eligible or cannot tolerate a traditional colonoscopy. Flexible Sigmoidoscopy (Flex Sig) WHAT IT IS? A doctor uses a tool called a sigmoidoscope to look at the sigmoid colon (the last section of the bowel) and the rectum, removing any visible polyps. This is different from a colonoscopy because a colonoscopy allows the doctor to see the entire large intestine. Because less than half of the large intestine and all of the rectum can be seen with this method, they are often done in combination with the gFOBT or FIT test, to test for blood in the stool. Prior to this procedure, an enema is done to clean out the lower part of the colon and the rectum. HOW MUCH DOES IT COST? Screening tests must be covered by insurance. If abnormal, coverage for follow up colonoscopy should also be covered by insurance. WHEN SHOULD IT BE REPEATED? If normal, every five years or in combination with FIT or gFOBT. WHERE IS IT PERFORMED? Outpatient surgical center or hospital. THINGS TO CONSIDER This test does not visualize the entire colon, so it is not as thorough as a traditional colonoscopy. WHO IS A GOOD CANDIDATE? Most people are good candidates. Discuss this option with your physician to determine if it is appropriate for you. Capsule Colonoscopy WHAT IT IS? A capsule colonoscopy is a unique type of screening that involves swallowing a vitamin-size pill that contains a wireless camera. A capsule colonoscopy is different in that it is able to image the entire digestive tract — from mouth to rectum. This includes imaging areas that are not normally seen by a traditional colonoscopy, such as the small intestine. HOW MUCH DOES IT COST? Varies by insurance, but screening tests must typically be covered. WHEN SHOULD IT BE REPEATED? If normal, every five years. WHERE IS IT PERFORMED? The capsule will be given to you at your physician’s office. After swallowing it, you are free to go home. You will either need to return to your physician’s office to return the external recording equipment, or you may need to retrieve the capsule from your stool and return it, depending on which specific capsule you were given. THINGS TO CONSIDER This is generally a low-risk screening option, but there is a possibility that the capsule can become stuck and must be retrieved surgically. If polyps or abnormalities are found, a follow-up colonoscopy is required. WHO IS A GOOD CANDIDATE? A capsule colonoscopy is typically only an option for individuals who cannot or will not tolerate a traditional colonoscopy. Discuss this option with your physician if you are interested. Blood-Based Tests WHAT IT IS? There are currently no FDA approved blood-based screening tests – however, the research is accelerating quickly and options are rapidly emerging. There are two different types of blood-based screening tests for cancer: Single-Organ screening tests and Multi-Cancer Early Detection (MCED) screening tests. So, what’s the difference? Single-Organ Blood Screening Test: These look for only one type of cancer. A yearly sample needs to be taken. If you receive a positive result, a follow-up colonoscopy is required. Multi-Cancer Early Detection (MCED) Screening Tests: Some can detect more than 50 types of cancers in one test. These are designed to focus on tumors that are more aggressive. They are used alongside Single-Organ tests for more accurate results. THINGS TO CONSIDER There are currently no FDA-approved blood-based screening tests; however, the research is accelerating quickly and soon there may be more options. Manufacturers are working to ensure coverage of additional screening tests as they are approved by the FDA, but it is best to call your insurance provider to determine screening tests that are and are not covered. Colorectal Cancer Screening Resources Read Colorectal Cancer Screening Brochure Colonoscopy Prep Tips Save a Life Rack Card Watch What to Expect (Colonoscopy) The Importance of Screening Risks and Risk Reduction Polyps and Prevention Screening Trends in the U.S. All About Polyps Addressing CRC Screening in African American and Medically Underserved Communities Listen Screening And Awareness with Yla Flores Advocating for Colorectal Cancer Screening African American Men and Colorectal Cancer Polyps Colorectal cancers often take many years to grow, and most start off as polyps. A polyp is a group of cells that grow together on the inside of the colon or rectum. Some polyps grow on the end of a stalk and look similar to a mushroom (this is called a pedunculated polyp), and some polyps, known as sessile or flat polyps, grow without the narrow stalk. Removing polyps can eliminate the chance they will turn into cancer. Not all polyps will become cancer, but it is important to remove them all to eliminate the possibility. Polyps can be detected and removed during a colonoscopy. To learn more, visit our colon polyps page. Courtesy of Dr. Swati G. Patel learn more about colon polyps Results What Can a Colonoscopy Detect? During a colonoscopy, your doctor uses a camera attached to a long tube to visually examine the lining of your colon for growths, inflammation and sores. Based on what they find, they may take a biopsy that’s sent to a lab for testing. Through this combination of visual examination and biopsy analysis, your doctor can identify a range of conditions, including: Polyps Cancerous Tissues Crohn's Disease Ulcerative Colitis Diverticulosis Hemorrhoids learn more about colonoscopies What If My Test Results Are Positive? Not all positive tests mean you have polyps or colorectal cancer. If you have a positive stool test, CT colonography, or blood test, the next step is a colonoscopy to evaluate the positive result. This will be considered a follow-up colonoscopy. If you have a colonoscopy and polyps are detected, your doctor will remove them and likely send them away for analysis. If your polyp analysis results are positive for colorectal cancer, we're right here with you. Our community of relentless champions is here for you, too. newly diagnosed or know someone who is? click here. Barriers to Screening As an advocacy organization, we are relentlessly fighting to remove any and all barriers to colorectal cancer screenings. Learn more about our policy efforts that are pushing lawmakers to remove barriers to colorectal cancer screening. get involved in advocacy Back to Top