Doctors are urging people to start paying attention to colorectal cancer earlier, as cases rise in people under 50 and the American Cancer Society broadens screening options beyond colonoscopy. The updated guidance now includes FDA-approved blood tests and at-home stool tests, while still encouraging screening to begin at age 45.
The shift reflects a hard reality: colorectal cancer is one of the most preventable cancers, yet it can advance without obvious warning. Lee Hicks said the disease can no longer be treated as something that only affects older adults, and that people should not be shy about discussing stool changes because screening can save lives.
Hicks said about 73% of the population gets screened in some form, and that national deaths from colon cancer have fallen by roughly 70% over the last 35 years. Even so, the disease remains a serious problem in younger patients, especially in Kentucky, where deaths are nearly 24% above the national average.
Doctors say the symptoms that should prompt a conversation about testing include changes in stool or blood, persistent stomach pain, anemia and fatigue. Hicks said the danger is that the disease may not announce itself until it is advanced, which is why people cannot rely on bowel movements alone to reassure themselves they are in the clear.
Colonoscopy remains the most important test, Hicks said, but the new guidance makes room for options that may be easier for some people to use. He said Cologuard is helpful, but it misses 10% of cancers, making the choice between tests less about perfection than about getting screened at all.
Doctors say the new guidance does not settle every question, especially about how much the blood tests will improve detection or cut deaths compared with colonoscopy. But the message is clear enough for now: with colorectal cancer rising under 50, the safest move is to talk to a physician about which screening test fits best and to start by 45.
