WHEN TO SCREEN FOR COLON CANCER

Screening begins at 45

The rising rate of colorectal cancer among younger people is one of the reasons the American Cancer Society (ACS) lowered its recommended screening age from 50 to 45.1 Doing so has increased awareness, with the goal of saving more lives. So if you’re already, or about to turn 45, now is the time to start planning your first screening.

By Exact Sciences Corporation | December 19, 2025

A woman is being shown her medical chart as she consults with her doctor.

Colon cancer is often considered the most preventable, yet least prevented cancer.2 A lot of people won’t have any symptoms, especially in its early stages.3 And despite what some may believe, most colon cancers happen to those without a family history of the disease.4 This is why early detection is key through timely screenings. When caught in its early stages, colon cancer is survivable in about 90% of people.*5

Start with Cologuard

Weighing your risks

You are considered average risk if you do not have:


  • A personal or family history of colorectal cancer
  • A history of inflammatory bowel disease, such as ulcerative colitis or Crohn’s
  • A history of abdominal or pelvic radiation for a past cancer diagnosis

If you meet the above criteria, it is recommended to start getting screened between the ages of 45 and 75. If you're 75 or older, please discuss your screening needs with your doctor so they can recommend the next best steps.


Aside from having a personal or family history of colon cancer, people who have inherited genetic syndromes, such as familial adenomatous polyposis (FAP) or Lynch, are considered to be high-risk. If you fall into this category, it is best to consult with your doctor so they can help you decide the best screening schedule based on your history.

Now screening

When it comes to screening options, you have choices beyond a colonoscopy. Let’s look into each method so you can decide which one will work best for you and your lifestyle.


Take note that if you choose one of the noninvasive options and it yields a positive result, you will need to follow it up with a colonoscopy.

1. Colonoscopy

What it is:


  • A flexible tube with a camera at its tip called a colonoscope is inserted into the rectum
  • The camera will show the inside of your colon, so the operator can identify any polyps (small growths) inside it
  • These polyps, along with any biopsy (tissue samples), can be removed during the procedure

Requirements:


  • A complete colon cleanse with bowel prep (laxatives)
  • A low-fiber diet two to three days before, followed by a liquids-only diet the day before
  • Sedation before the procedure

2. Virtual colonoscopy 

What it is:


  • Also known as a CT colonography
  • Less invasive than a colonoscopy
  • Uses a CT scan to capture detailed images of the colon and rectum for polyps
  • No sedation is needed 

Requirements:


  • A complete colon cleanse with bowel prep (laxatives)
  • A liquids-only diet the day before
  • Fasting (no food or drink) a few hours before the procedure

3. Fecal immunochemical test (FIT):

What it is:


  • An over-the-counter test that detects occult (hidden) blood in the stool
  • Blood in the stool can be a sign of precancerous polyps or colon cancer
  • Noninvasive and can be used at home, but a stool sample needs to be sent back to the lab for testing
  • A positive result requires a colonoscopy

Requirements:


  • No prep or special diet is required 
  • No medication is required 
  • No downtime 

4. Guaiac-based fecal occult blood test (gFOBT):

What it is:


  • Just like a FIT, a gFOBT is an over-the-counter test that detects occult blood in the stool
  • Uses guaiac, a chemical that can detect blood up the digestive track, including the stomach
  • Noninvasive and can be used at home, but stool samples need to be sent back to the lab for testing
  • A positive result requires a colonoscopy

Requirements:


  • NSAIDs such as naproxen, ibuprofen, or aspirin should not be taken 7 days before testing
  • Vitamin C in fruits or supplements should be avoided 3 days before testing
  • Red meat, as well as raw fruits and vegetables, are not allowed
  • Because it needs at least 3 bowel movements, a single test can take a few days to complete

5. Cologuard® stool DNA test

What it is:


  • Currently, the only FDA-approved stool DNA test is Cologuard
  • Noninvasive and prescription-based, it finds abnormal DNA from cells, as well as tiny amounts of blood in the stool, to detect cancer and precancer
  • Can be used at home, but a stool sample needs to be sent back to the lab for testing
  • A positive result requires a colonoscopy

Requirements:


  • No prep or special diet is required
  • No medication is required
  • No downtime

Getting screened at 45

In the same year that Dorothy became eligible to screen for colon cancer, she got the devastating news that a friend had it. Wanting to honor him, Dorothy wasted no time – she researched her options and decided to screen with Cologuard. When her test came back positive, Dorothy got a stage 1 diagnosis after a colonoscopy.


Five years later, this is her story.

Dorothy smiles as she is interviewed about her colon cancer journey.

A friend's colon cancer diagnosis became Dorothy's reason to get screened at 45.

With screening, timing is everything 

Colon cancer can take about 10 years to develop.6 By the time symptoms manifest, it may be so advanced that treatment is more difficult, with diminishing chances of survival. Early detection can mean a world of difference when the cancer is still small and has not yet spread. The only way to do this is to get timely and regular screenings.


If you’re 45, take this as a sign to get screened. Share with your family and friends and help spread the word. And if a colonoscopy is overwhelming, especially for first-timers, let them know there are several noninvasive, use-at-home screening options to choose from, such as Cologuard.

Safe.
Noninvasive.
FDA-approved.

Request Cologuard