FixYou

Colorectal Cancer Screening Now Starts at 45

3 min read

In 2021, the USPSTF lowered the recommended starting age for colorectal cancer screening from 50 to 45. Nearly five years later, most adults in the 45-49 age group still haven't been screened.

Colorectal screening rate by age groupAges 45–4937.1%Ages 50–7573.4%0%50%100%

Source: CDC National Health Interview Survey, 2023

As of 2023, only 37.1% of adults aged 45-49 had been screened, compared to 73.4% of those aged 50-75. That 36-point gap represents millions of people missing a screening that insurance is required to cover at no cost.

Why the age changed

Colorectal cancer rates among adults under 50 have been climbing steadily. It's now the second leading cause of cancer death in the US overall, and the leading cause in adults under 50. Waiting until 50 means missing a window where screening could catch problems early.

You don't need a colonoscopy to start

A lot of people put off screening because they think it means a colonoscopy. It doesn't have to.

A fecal immunochemical test (FIT) is a simple at-home stool test that takes minutes and is done once a year. Take-up of stool-based tests in the 45-49 group has more than quintupled since 2019, from 1.3% to 7.1%. Colonoscopy in this age group also rose, from 19.5% to 27.7%. Progress is happening, but not fast enough.

Colonoscopy remains the most thorough option (every 10 years if normal) and has a unique advantage: it can remove precancerous polyps during the procedure, actually preventing cancer rather than just detecting it.

What's at stake

Colorectal cancer caught early has a 91% five-year survival rate. Caught late, that drops to 15%. CISNET modeling estimated that just a 10-percentage-point increase in colorectal screening uptake could prevent 11,070 additional deaths over the lifetimes of newly screened individuals — more than lung, breast, and cervical screening increases combined.

If you're 45 or older and haven't been screened, now is the time. fixyou.app tells you which screenings apply to you based on your age, risk factors, and family history. Under 2 minutes. Free, in English and Chinese.