Colon cancer is no longer a disease that patients can assume only affects older adults. While overall colorectal cancer rates have declined over time—largely because screening helps find and remove precancerous polyps—new diagnoses are increasing in younger adults, and recent research continues to reinforce the need for awareness and early action.
The good news is this: colorectal cancer is one of the most preventable cancers when caught early. Screening can detect polyps before they turn into cancer, and it can also find cancer earlier, when treatment is often more effective, and outcomes are better. The National Cancer Institute notes that screening not only helps detect disease sooner, but can actually prevent cancer by identifying and removing precancerous growths.
Recent findings underscore why this matters. American Cancer Society reporting published in 2025 found colorectal cancer incidence increased steadily in adults ages 20–39 and 40–44, and also rose in adults 50–54. Among adults ages 45–49, incidence accelerated sharply from 2019 to 2022, with localized tumors rising as screening expanded in that age group—evidence that screening is helping detect cancers earlier.
That trend is part of a larger shift. According to the American Cancer Society’s 2026 statistics update, colorectal cancer incidence in people younger than 50 increased by 2.9% per year from 2013 to 2022, while rates in adults ages 50–64 also rose modestly.
When should patients start regular screening?
For adults at average risk, both the American Cancer Society and the U.S. Preventive Services Task Force recommend starting regular colorectal cancer screening at age 45. Screening should continue through age 75 for people in good health. For adults ages 76 to 85, the decision should be individualized based on overall health, life expectancy, prior screening history, and patient preference. People older than 85 are generally not advised to continue routine screening.
Best-practice screening options for average-risk adults include:
- Colonoscopy every 10 years
- FIT (fecal immunochemical test) every year
- High-sensitivity stool blood test every year
- Stool DNA-FIT every 1 to 3 years
A timely colonoscopy should follow any abnormal result from a stool-based test.
Who may need screening earlier than 45?
Some patients should talk with their provider about starting earlier or having a colonoscopy more often. This includes people with:
- A family history of colorectal cancer or advanced polyps
- A personal history of colorectal cancer or certain polyps
- Inflammatory bowel disease, including Crohn’s disease or ulcerative colitis
- A known or suspected hereditary syndrome, such as Lynch syndrome or familial adenomatous polyposis
- A history of abdominal or pelvic radiation for a prior cancer
When should a patient have a colonoscopy because of symptoms?
Routine screening is meant for patients without symptoms. When symptoms are present, the conversation changes from screening to diagnostic evaluation. Patients should not wait until the “right screening age” if they are experiencing warning signs.
Symptoms that should prompt medical evaluation include:
- Blood in or on the stool
- A change in bowel habits
- Diarrhea or constipation that does not improve
- A feeling that the bowel does not empty completely
- Abdominal pain, aches, or cramps that do not go away
- Unexplained weight loss
Research highlighted by the National Cancer Institute found four warning signs that may be especially important in younger adults: abdominal pain, rectal bleeding, diarrhea, and iron-deficiency anemia. Even one of these signs was associated with nearly twice the likelihood of an early-onset colorectal cancer diagnosis, and three or more signs were associated with a sixfold increase.
The takeaway for patients
Do not ignore symptoms, and do not assume you are too young. If you are 45 or older and have not started routine colorectal cancer screening, now is the time to talk with your provider. If you have symptoms—or a personal or family history that raises your risk—ask whether a colonoscopy or other diagnostic evaluation is appropriate sooner. Earlier detection can make a life-changing difference.
