The American Cancer Society (ACS) has released a new guideline for colorectal cancer screening recommending that screening should begin at 45 years of age instead of 50.
In a study led by the ACS, researchers found that clinicians reported new cases of colorectal cancer in young and middle-aged adults at a steadily increasing rate in the U.S. from 1974 to 2013. Incidence rates have gone up by as much as 3% per year in individuals between the ages of 20 and 54 (Journal of the National Cancer Institute, February 28, 2018).
The society has updated its colorectal cancer screening guideline in light of these and similar findings. The new recommendations include the following:
- Individuals at average risk of colorectal cancer should start screening at 45 years.
- Healthy individuals with a life expectancy of more than 10 years should continue regular screening through the age of 75.
- Individuals between 76 years and 85 years should seek screening on a case-by-case basis.
- Individuals older than 85 years should avoid screening.
The recommended screening exams for colorectal cancer include CT colonography, colonoscopy, flexible sigmoidoscopy, and various stool-based tests.
![Axial images from unenhanced calcium score cardiac CT (left) and curved planar reformation images from CT angiography (right) show that higher long-term exposure to air pollution is associated with greater coronary artery calcium and more obstructive coronary artery disease (CAD). Top row: Images in a 68-year-old male patient with higher 10-year mean ambient air pollution exposure (7.9 μg/m3 for particulate matter measuring ≤2.5 μm in diameter [PM2.5] and 17.4 parts per billion [ppb] for NO2) with extensive CAD (coronary artery calcium score [CACS] >1,000 and obstructive CAD [≥70% diameter stenosis]). Bottom row: Images in a 57-year-old female patient with lower 10-year mean ambient air pollution exposure (6.3 μg/m3 for PM2.5 and 4.6 ppb for NO2) with no CAD (CACS = 0 and no obstructive stenosis).](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/06/hanneman.r6SMLzkezo.png?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
