In 2021, guidelines for colorectal screenings changed to age 45 instead of 50 for those at average risk.

“The American Cancer Society noted significantly more colorectal cancers at younger ages, looking at data from 1995-2019,” Dr. Susan Owensby, a medical director for BlueCross BlueShield of Tennessee says. “It’s important to understand how screenings can catch and even prevent certain colorectal cancers.”

They estimated that about 12% of colorectal cancer cases would be diagnosed in people under the age of 50 by 2020.

WellTuned spoke to Dr. Owensby to learn more about these important screenings.

What is the colon cancer screening recommendation?

Dr. Owensby: Those considered at average risk for colon cancer should begin colorectal cancer screenings at age 45.

If you have a higher risk for colorectal cancer, talk to your doctor to see if you need screenings before age 45. These risk factors include:

• Family history of colorectal cancer or certain types of polyps
• Personal history of colorectal cancer or certain types of polyps
• History of inflammatory bowel disease (such as ulcerative colitis or Crohn’s disease)
• A known or suspected family history of a hereditary colorectal cancer syndrome, such as familial adenomatous polyposis (FAP) or Lynch syndrome
• History of radiation to the abdomen or pelvic area to treat a prior cancer

“Find out your family history, especially if you have a relative diagnosed with colon cancer or other cancers at younger ages.”

What are your screening options?

Dr. Owensby: Colorectal screenings can detect growths called polyps on the lining of the intestines. Not all polyps are cancerous but  some may become so over time.

These screenings can help find colorectal cancer early, when it’s usually small, hasn’t spread, and might be easier to treat.

Screenings are more accessible than ever because:

• More procedures are being done at outpatient centers and hospitals.
• And there’s an increased availability of in-home stool sample testing.

Screening options include:

• Visual (structural) exams: Colonoscopy or sigmoidoscopy look at the structure of the colon and rectum for abnormal areas. This is done either with a scope (a tube-like instrument with a light and tiny video camera) or with special X-ray tests.
• Stool-based tests: These check the stool (feces) for signs of cancer. These are less invasive and can often be done at home. To note:
  • These tests may need to be done more frequently than visual exams
  • If an abnormality is detected, you will then need a colonoscopy

“Colonoscopy is the most comprehensive screening because it gives a view of the whole intestine,” Dr. Owensby explains. “And with normal findings, it’s possible that you may only need a few colonoscopies over the course of your lifetime.”

But the most important benefit of early screening is the possibility of reducing negative outcomes by catching colon cancer early when it can be easier to treat.

“It breaks my heart to see a later stage colon cancer diagnosis because it’s so avoidable with regular screenings,” she says.

Lifestyle changes that could impact your colon cancer risk:

• Maintain a healthy weight. Being overweight or obese raises the risk of colon and rectal cancer in people, with the risk slightly higher in men. Getting to, and staying at, a healthy weight may help lower your risk.
• Get active. Participating in moderate to vigorous physical activity on a regular basis can help lower your risk.
• Watch your diet. Limit red meats (beef, pork, lamb, or liver) and processed meats (hot dogs and some luncheon meats). Avoid cooking meats at very high temperatures as this creates chemicals known to raise cancer risk.
• Get your Vitamin D. Keep your vitamin D blood level at a healthy range to help reduce risk.
• Stop smoking. While smoking is a well-known cause of lung cancer, it has also been linked to other cancers as well. See this Guide to Quitting Smoking.
• Limit alcohol intake. Moderate to heavy alcohol use has been linked to colon cancer. Even light-to-moderate alcohol intake has been associated with some risk. If you drink alcohol, doctors recommend no more than 2 drinks a day for men and 1 drink a day for women.

Get more information about specific health terms, topics and conditions to better manage your health on bcbst.com. BlueCross BlueShield of Tennessee members can access wellness-related discounts on fitness products, gym memberships, healthy eating and more through Blue365®. BCBST members can also find tools and resources to help improve health and well-being by logging into BlueAccess and going to the Managing Your Health tab.