Colorectal cancer is the second leading cause of cancer-related deaths in the United States for both men and women. This year, approximately 153,000 new cases of colorectal cancer will be diagnosed, and 53,000 people will die from the disease. Having regular screenings is essential and beneficial for two 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, colorectal cancer or polyps, or ovarian, endometrial or breast cancer. In 2018, the American Cancer Society lowered the screening age from 50 to 45 because 10% of colorectal cancer deaths occur between the ages of 45-49. Between 80-90% 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 screenings are recommended beginning at age 45, younger individuals – born around or 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. This form of cancer is emerging in people that have essentially no other medical problems. Based on recent statistics, 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 clinicians may not be aware of the increased rate of young people being diagnosed with colorectal cancer. The symptoms presented in younger patients could be discounted because of their age.

Due to the prevalence of the disease in younger people and how this form of cancer manifests itself, patients should be encouraged to talk to their health care provider about preventative screenings and physical exams to identify colorectal cancer, especially if they are experiencing abnormal symptoms.

Screenings are usually covered by insurance; however, 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 by insurance 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 who are underinsured. Medicaid covers colorectal screening and genetic testing. There is much room to screen more effectively for those not yet engaged or benefiting due to other factors such as race, socioeconomics/poverty, geography, sex, age and educational attainment.

Learn more about colorectal cancer and early-age onset colorectal cancer here. To find a location to be screened for colon and rectal cancer, visit You can also call the UofL Health – Brown Cancer Center – Cancer Screening Program at 502-210-4497. If you have symptoms, talk with your primary care provider as soon as possible.

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Article by: 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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