Colon Cancer Screening

Colon cancer is one of the most common cancers in the US and worldwide. Up-to-date statistics can be found at the Colon Cancer Alliance webpage.

The official recommendations are from the US Preventative Screening Task Force. In general, if you are 45 years or older, you should speak with your doctor about getting screened for colon cancer. If you already had a screen, it is likely that you have been guided on when you need to repeat.

Very important: the screening guidelines are for “average risk patients”. They are NOT for people who have medical conditions such as Crohn’s Disease, Ulcerative Colitis or a family history of Lynch Syndrome. Also, if a first degree relative has or had colon cancer (not polyps) you are considered higher risk and will likely need a more intense screen.

Also, symptoms such as rectal bleeding or changes in bowel habits may make certain testing options unsuitable for patients.

Here in 2025, the most commonly used screening tests are the colonoscopy and Cologuard ^TM (the “at-home poop-in-the-box test.”)

An older but still used option is home stool-card tests, which assess for blood and other elements. Two even older screening tools, sigmoidoscopy (a shorter version of the colonoscopy) and the barium enema remain available but have been demoted in favor of better technologies.

A new method for colon cancer uses a blood test. (Shield ^TM) However, that is not being done widely yet. In fact, there remains concerns about it’s ability to detect polyps. I have not employed it yet in my practice, but will continue to watch the data.

With all these options, it is very important to speak with your primary carer provider or gastroenterologist about which screen is most appropriate for you and at what age you need to start.

Bottom line: If you are 45 years or older and you have not had any screening test yet, reach out to your PCP today. You’re due. Also, encourage your friends and family members to get their tests done. I’ve seen too many of my patients delay and end up with worse outcomes from colon cancer.