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In this article:
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There are many myths surrounding colorectal cancer screening. We debunk some of them and give you the real story.
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Cancer screening guidelines have changed — now, doctors recommend that people at average risk of colorectal cancer start screening at age 45.
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There are two main types of colorectal cancer screening—colonoscopies and fecal immunochemical tests (FITs).
While colorectal cancer is the third-most-common cancer in adults in the United States, it is perhaps one of the most preventable. Other types of cancer may cause symptoms only in late stages, but you can often catch colorectal cancer before it fully develops into a life-threatening problem.
The challenge is to move past all the myths and misconceptions that could prevent you from finding the care you need. Here, we explore some of the most common myths and the facts behind those myths.
Myth: Only older people get colorectal cancer.
Although the risk of developing colorectal cancer increases with age, the number of adults younger than 50 diagnosed with this disease goes up every year, according to the American Cancer Society. If you’re Black, African American or Jewish with Eastern European heritage, you are at greater risk than people in other racial or ethnic groups.
Additional risk factors include:
- Obesity
- Smoking
- Family history of colorectal polyps or cancer
- Personal history of inflammatory bowel diseases such as Crohn’s disease or ulcerative colitis
- Moderate to heavy alcohol consumption
A colonoscopy is the only form of colorectal cancer screening, and it’s a difficult, uncomfortable procedure.
Colonoscopies may have a bad reputation, but in reality, you’ll be given medication that helps you sleep and minimizes your discomfort during the procedure. Even the preparation has gotten easier as experts have refined the process over time.
In addition to colonoscopies, several screening options are available, including a simple, take-home option known as the fecal immunochemical test (FIT). Both types of screenings can detect precancerous polyps in the colon. Regardless of which screening you have, the most important thing is to follow your doctor’s recommendations afterward. If you have a positive FIT test, you will need a colonoscopy. If you have a colonoscopy and the doctor removes polyps, you'll need to return for follow-up colonoscopies on a regular schedule.
Colonoscopy
A colonoscopy uses a lighted, flexible tool to view the complete lining of the colon. During this test, the doctor will look for precancerous growths (polyps). A colonoscopy happens while you’re asleep (sedated) and requires clearing the colon with medicine (laxatives).
Preparation for a colonoscopy involves adopting a low-fiber diet for a few days prior to the procedure. The day before the test, you will consume only clear liquids, and you will drink a laxative about 12-18 hours beforehand. It’s best to stay close to a bathroom the night before a colonoscopy.
If no polyps are found during the procedure, this test only needs to be performed about once every 10 years.
FITs
FITs (including Cologuard) detect hidden blood in the stool and use DNA to detect cancer cells. Your doctor will give you the kit to take home with you, along with detailed instructions on how to use it. These tests require you to collect samples of your stool.
If results come back negative, your doctor will probably recommend you repeat the test one to two times a year. If positive, then you’ll need a colonoscopy.
Speak with your primary care doctor about which type of screening is best for you.
Myth: You can wait until you’re 50 to start colorectal cancer screenings.
While colorectal cancer rates have decreased overall, they have actually increased in people younger than age 50. As a result, the American Cancer Society now recommends that both men and women start undergoing screening colonoscopies at age 45. Talk to your doctor about whether you should have a colonoscopy.
Once you have your first screening, your doctor can help you develop a schedule for future screenings. For example, if they find precancerous polyps during a colonoscopy, they will probably recommend that you undergo another screening in five years. If they don’t find anything, you may be able to wait another 10 years.
Myth: If your doctor finds polyps during your colonoscopy, they are probably precancerous.
When your doctor finds one or more polyps (or tissue growths on the inner lining of the colon), they remove them during the procedure and send them to a laboratory for microscopic analysis. Approximately two-thirds of polyps that are removed during colonoscopies are not cancerous, so, there’s no need to panic if your doctor tells you they found polyps. Even if the polyps are precancerous, they have now been removed — which is why colorectal cancer screenings are so important.
Myth: Colorectal cancer screening is only for people with symptoms.
Even if you feel fine, you should still follow the American Cancer Society’s recommendations for screenings. Cancer does not always have recognizable symptoms when it’s just beginning, and that’s when it’s easiest to treat.
Symptoms to watch for include:
- Rectal bleeding (the most common symptom)
- Pain when using the bathroom
- Unintentional weight loss
- Unexplained new constipation or other changes in bowel habits
Speak with your primary care provider for more information on colorectal cancer screenings. Make sure they are aware of any family history of colorectal cancer. And if it’s time for your first (or next) colonoscopy, don’t put it off. It could save your life!
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Schedule a colonoscopy and find a doctor
You can schedule a colorectal cancer screening without a physician referral. If you need to find a doctor, you can use our provider directory. Through Providence Express Care Virtual, you can also access a full range of healthcare services.
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Related resources
Which cancer screenings should you undergo?
Low-fiber diet for colonoscopy prep
Colorectal cancer screening in at-risk communities
This information is not intended as a substitute for professional medical care. Always follow your health care professional’s instructions.
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