April 2026
At Providence Cancer Institute, screening decisions are personal. Dr. Kelly Perlewitz, medical director of Hematology and Oncology at Providence Cancer Institute, shares tips on when you should start getting screened and the key differences between a colonoscopy and a stool test.
Stories about colon cancer rising in younger adults have raised important questions, and guidelines have recently changed to reflect what we’re seeing nationwide.
"For average-risk people, colon cancer screening should start at age 45. If you have a family history of colon cancer or polyps, that age may be younger," Dr. Perlewitz says.
Most people don’t realize they’re at risk
Many people assume colon cancer only affects those with a strong family history — but that’s not the case. In fact, about 70–80% of people diagnosed with colon cancer do not have a family history. Across the general population, roughly 4% of people will develop colon cancer in their lifetime.
That’s why routine screening is so important, even if you feel healthy and have no symptoms. Screening saves lives by finding cancer early — or preventing it altogether.
Colon cancer is highly preventable when it’s caught early, and today’s screening options are more accessible and effective than ever.
Understanding your screening options
A colonoscopy is considered the gold standard for screening. It requires a bowel prep and an appointment with a doctor who uses. a small camera to examine the colon.
For people who prefer a noninvasive option, there is a stool-based DNA test that can be completed at home without any prep or recovery time. Dr. Perlewitz explains that a stool-based test detects about 92% of colon cancers, though it identifies fewer precancerous polyps.
"If the stool-based test is positive, you would still need to get a colonoscopy," she says.
