Colorectal Cancer

What is it?

Colorectal cancer is cancer that begins in the colon or rectum (everyone has a colon and rectum unless they have been surgically removed). This cancer can be prevented with a screening colonoscopy by removing polyps (grape-like growths on the wall of the large intestine, which is part of the colon) before they become cancerous. With routine screening using colonoscopy or stool-based tests, you can also detect the disease early when the cancer is small and hasn’t spread.

Four adults in their 50s dressed in red baseball jerseys and caps. There is a Black man and woman and a whiteman and woman who are all linking arms and smiling. They appear to be on a team.

Get screened

For those of average risk, colorectal cancer screening should begin at age 45 (the recommended age was lowered from 50 to 45 in 2021).*

*Source: U.S. Preventive Services Task Force

Ages 45–75: Get screened

Start getting screened at age 45 if you’re at average risk for colorectal cancer. See below for more on the screening options that may be available for you. Continue getting screened through age 75 if you are in good health with a life expectancy of 10 years or more.

Ages 76–85: Talk to your doctor

If you are between the ages of 76–85, talk with your health care provider about whether to continue screening. After age 85, you should not get screened.

Increased risk vs. average risk

If you’re at increased risk for colorectal cancer, you may need to start regular screening at an earlier age and/or be screened more often.

If you’re at average risk, that means you do not have:

A personal history of inflammatory bowel disease (such as ulcerative colitis or Crohn’s disease).
A personal history of colorectal cancer or certain kinds of polyps (adenomatous or “flat” polyps).
A family history of colorectal cancer.
Hereditary colorectal cancer syndrome (such as familial adenomatous polyposis [FAP] or Lynch syndrome).

Screening options

Test	Screening Interval
Colonoscopy	Every 10 years
Virtual colonoscopy*	Every 5 years
Flexible sigmoidoscopy*	Every 5 years
High sensitivity guaiac based fecal occult blood test (HS gFOBT)*	Every year
Fecal immunochemical test (FIT)*	Every year
Multitarget stool DNA test (mt-sDNA)*	Every 3 years

*An abnormal result of a virtual colonoscopy or flexible sigmoidoscopy, a positive FOBT, FIT or sDNA test should be followed up with a timely colonoscopy.

Know your risk

You are at increased risk for colorectal cancer if you:

Are age 50 or older.
Are Black.
Smoke.
Are overweight or obese.
Have Type 2 diabetes.
Are not physically active.
Drink alcohol in excess.
Eat a lot of red meat (such as beef, pork or lamb) or processed meat (such as bacon, sausage, hot dogs or cold cuts).
Have a personal or family history of colorectal cancer or colorectal polyps (adenomas).
Have a personal history of inflammatory bowel disease (such as ulcerative colitis or Crohn’s disease).

Reduce your risk

You may reduce your risk for colorectal cancer through these lifestyle-related modifications:

Exercise for at least 30 minutes, at least 5 days a week.

Avoid or limit alcohol.

To reduce your risk of cancer, it’s best to avoid alcohol completely. If you do choose to drink, limit your drinking to no more than one drink a day if you were assigned female at birth, and no more than two drinks a day if you were assigned male at birth.

Do not smoke or use tobacco in any way.

If you do, quit.

Eat less red meat and cut out processed meat.

Maintain a healthy weight.

Eat lots of fruits, vegetables, beans and whole grains.

Get screened for colorectal cancer based on guidelines and your personal risk factors.

Signs & symptoms

Talk with your health care provider right away if you experience any of the following symptoms:

Bleeding from the rectum or blood in or on the stool
Change in bowel movements that lasts more than a few days
Stools that are more narrow than usual
General abdominal problems such as bloating, fullness or cramps
Diarrhea, bleeding or constipation or a feeling in the rectum that the bowel movement is not quite complete
Weight loss for no apparent reason
Feeling very tired all the time
Vomiting

Treatment options

Treatment depends on the stage of the cancer, the type of tumor cells and your medical condition.

Surgery

The most common treatment for colorectal cancer is surgery. This can range from a partial colectomy (removal of part of the colon, also called a colon resection) to a proctocolectomy (removal of the large intestine and the rectum).

Chemotherapy

Chemotherapy uses drugs to kill cancer cells. If the cancer has spread, chemotherapy may be used before or after surgery.

Radiation

This treatment uses high doses of radiation to kill cancer cells and shrink tumors. When the cancer has spread, radiation may be used before or after surgery.

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