Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States for both men and women combined. This year, approximately 140,000 new cases of CRC will be diagnosed, and 56,000 people will die from the disease. Regular screening is essential and is beneficial for two main reasons: colorectal cancer is preventable if polyps that lead to the cancer are detected and removed, and it is curable if the cancer is detected in its early stages.

Individuals should get regular colorectal cancer screenings beginning at age 45 or earlier if there is a personal or family history of inflammatory bowel disease; CRC or polyps; or ovarian, endometrial, or breast cancer. In 2018, the American Cancer Society lowered the screening age from 50 to 45 because 10 percent of colorectal cancer deaths occur between the ages of 45 – 49. Between 80 – 90 percent of colorectal cancer patients are restored to normal health if their cancer is detected and treated in the earliest stages.

Born after 1990? You may be at a higher risk.

Though routine screening is recommended beginning at age 45, younger individuals – born around/after 1990 – are encouraged to be mindful of any unusual symptoms including blood in the stool. The U.S. is currently facing an epidemic of young people with colon and rectal cancer that is presenting in people that have essentially no other medical problems. Based on actuarial data, if you were born after the year 1990, your risk for developing colon and rectal cancer is roughly six times what it would be for your parents over the course of your lifetime.

In this group of younger people, the disease is often more deadly because most clinicians do not have the raised awareness of young people being diagnosed with colorectal cancer. The symptoms younger patients present with could be discounted because of their age.

Due to the prevalence of the disease in younger people and how the disease manifests itself, patients should be encouraged to talk to their health care provider about preventative screenings and physical exams to identify colorectal cancer.

Screenings are usually covered by insurance; screening assistance is available.

Most colorectal cancer screenings are covered by insurance if patients are at normal risk at the age of 45, or if they are at a higher risk due to a family history of polyps or colorectal cancer. There are different types of screenings. The major types which are all covered are:

  • Colonoscopy
  • A structural TST or take-at-home stool test including FIT or Stool DNA such as Cologuard ® which looks for blood in the stool or both blood and DNA changes suggestive of colorectal cancer. A positive take-at-home test must have a colonoscopy to complete the screening process.

With new guidelines, many regular health screenings have been missed. There are approximately 22.5 million people nationwide between the ages of 45-49 who have not been screened for colorectal cancer. The Kentucky Colon Cancer Screening Program (KCCSP) provides screenings for those with no insurance or under-insured. Medicaid covers colorectal screening and genetic testing. There is much room to screen more effectively for those not yet engaged nor benefiting due to other factors such as race, socioeconomics/poverty, geography, sex, age, and educational attainment.

To learn more about colorectal cancer and Early-Age Onset colorectal cancer click here. To find a location to be screened for colon and rectal cancer, visit If you have symptoms, talk with your primary care provider as soon as possible. To make an appointment with UofL Health – Primary Care, please call 502-588-4343.

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Shiela Rhoads, M.D.

Shiela Rhoads, M.D. is a board-certified gastroenterologist specializing in all aspects of diagnostic and therapeutic endoscopy with special interest in women’s issues, general gastroenterology, Barrett’s Esophagus and gastroesophageal reflux disease (GERD). A graduate of the University of Louisville School of Medicine, Dr. Rhoads did her fellowship training at the Henry Ford Hospital in Detroit, Mich. She has been practicing gastroenterology medicine in the Louisville area since 2007.

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