Colon Cancer Screening Now Starts at 45

Why did the screening age drop to 45?

You may remember 50 as the number. In 2021, the US Preventive Services Task Force lowered it to 45 for average-risk adults. The reason was not a mistake or a trend. Rates of colorectal cancer in people under 50 have been rising for years, and doctors were seeing more cases in people who had no family history and no obvious risk factors.

The drop to 45 means more women in perimenopause are now in the screening window. If you are 45 to 49 and have not been screened, you are not behind. You are exactly the person this change was made for. The goal is to find changes early, when they are easiest to address.

What are my screening options, and which one is right for me?

You have choices. A colonoscopy is the most thorough: a doctor looks at the entire colon and can remove polyps during the same visit. It requires bowel prep and sedation. A stool-based test, like FIT or a multi-target stool DNA test, is done at home and returned by mail. If it is positive, you will still need a colonoscopy.

Which one is right for you depends on your risk, your history, and what you will actually complete. Some women prefer the certainty of a colonoscopy every 10 years. Others prefer a stool test every 1 to 3 years. Neither is wrong. The best screening is the one you follow through on. Talk with your provider about your family history and any symptoms you are having.

Which symptoms do women blame on hormones or IBS?

You have probably been told your symptoms are hormonal, stress-related, or just part of getting older. Some of them may be. But colorectal cancer can cause changes that look like perimenopause or irritable bowel syndrome: a shift in bowel habits that lasts more than a few weeks, narrow stools, a feeling that you cannot fully empty your bowel, or blood in your stool or on toilet paper.

You may also notice bloating that does not come and go, unexplained weight loss, or fatigue that does not improve with rest. These can have many causes, and most of the time they are not cancer. But if you have any of them, especially blood or a lasting change in your bowel habits, call your provider. Do not wait for your next appointment.

What should I do if I have been waved off before?

If you have raised these symptoms and were told it is stress, hormones, or IBS without any testing, you are not imagining it. That happens to many women. You can ask directly: I would like to be screened for colorectal cancer. I am 45 or older, or I have these symptoms, and I want to rule it out. Ask for the test by name.

You can also ask what your options are and which one they recommend for you. If you are not satisfied, you can ask for a second opinion. You are not being difficult. You are being clear. And if you have blood in your stool, call your provider now. That is not a wait-and-see symptom.

What helps

• Write down your symptoms with dates, so you can describe them clearly at your next visit.
• Ask your provider directly for colorectal cancer screening if you are 45 or older.
• If you choose a stool test, set a reminder to complete and return it on time.
• If you have blood in your stool, call your provider the same day rather than waiting.
• Keep a simple log of bowel changes, bloating, and fatigue to spot patterns over weeks.

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Mae’s picks

• at-home FIT stool test kit — A simple at-home option to discuss with your provider
• symptom and cycle tracking notebook — Helps you record bowel changes and bloating over time
• flushable moist wipes — Gentle for sensitive skin when you check for blood