‘A Call to Action’: Why New Research Is Shaking Up Colon Cancer Screening Guidelines for 2026
Colon cancer is rising in adults under 50—doctors explain when to screen and how to lower risk
If you’re in your 40s, you might think colon cancer is something to worry about decades from now. But alarming new research reveals a dramatic shift in colon cancer rates among Americans under 50. This year alone, an estimated 158,850 Americans will be newly diagnosed with colon cancer, according to the American Cancer Society. We asked doctors what this new research could mean for future screening guidelines—and got their simple tips to lower your colon cancer risk.
What is colon cancer?
As one of the most common cancers, you’ve likely heard of colon cancer, but you may not have a full picture of what’s happening in the body when someone receives a diagnosis.
“Colon cancer is a cancer that begins in the main, longest part of the large intestine, called the colon,” says Jennifer Chung, MD, a board-certified internist and a functional and lifestyle medicine specialist. “Cancers that start in the colon or rectum, which is the segment at the end of the colon, are often grouped together as colorectal cancer.”
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What causes colon cancer?
With large numbers of Americans being impacted by colon cancer every year, you might be wondering what even causes it? “Though some colon cancers are hereditary, meaning they arise from a genetic mutation passed down from a parent, most colon cancers are ‘sporadic,’ or occur randomly due to a combination of risk factors that damage healthy cells in the colon, turning them into cancerous cells,” says Dr. Chung.
And what are those risk factors? Steven Goldberg, MD, MBA, clinician and Chief Medical Officer of HealthTrackRx, shares several, including:
- Age: Colon cancer risk increases with age, but it’s increasingly more common for younger adults to develop it, says Dr. Goldberg.
- Family history: Having a sibling, parent or child with colon cancer can increase your risk, especially if they were diagnosed before age 50, says Dr. Goldberg.
- Genetic conditions: Inherited genetic syndromes like familial adenomatous polyposis (FAP) or Lynch syndrome significantly increase risk, says Dr. Goldberg.
- Inflammatory bowel disease: Crohn’s disease and ulcerative colitis both can increase risk, says Dr. Goldberg.
- Polyps: A personal history of colon polyps or a past colon cancer diagnosis can increase risk, says Dr. Goldberg.
Dr. Goldberg says factors that may be linked to colon cancer include physical inactivity, tobacco use, obesity, heavy alcohol consumption and type 2 diabetes, as well as dietary patterns such as eating a lot of red and processed meats and not getting enough fiber.
How does a person get screened for colon cancer?
Wondering how colon cancer screening works? Dr. Chung explains the range of options available.
Colonoscopy
“This involves the doctor inserting a thin, flexible tube with a camera ( a colonoscope) into the rectum and all through the colon,” says Dr. Chung. “This is considered the gold standard test because the doctor can look directly for pre-cancerous lesions, called polyps, and can remove them during the same procedure.”
Fecal occult blood test or fecal immunochemical test
“These tests involve applying a small amount of stool to a special card or sampling bottle, which can then be used to detect blood in the stool,” says Dr. Chung. “If your physician feels you are an appropriate candidate for one of these tests based on your medical history, these can be completed conveniently at home once a year in lieu of a colonoscopy.”
Cologuard
“This is a newer home stool test approved in 2014 that involves collecting a small sample of stool in a container,” says Dr. Chung. “It checks for 10 different DNA markers linked to colon cancer and traces of blood.”
Other methods
“There are also options to visualize the colon through a special CT scan, called a CT colonography, or just do a partial colonoscopy, called a sigmoidoscopy,” says Dr. Chung. “However, given their limitations, they are used in special circumstances and not widely recommended as standalone screening tests.”
New research on colon cancer screening age
So, when is it recommended you start the screening process for colon cancer? “The current guidelines from major health organizations like the U.S. Preventive Services Task Force and the American Cancer Society recommend that average-risk individuals begin colorectal cancer screening at age 45, once every 10 years,” explains Steven Lee-Kong, MD, Division Chief of Colorectal Surgery at Hackensack Meridian Hackensack University Medical Center.
But new JAMA research found that colorectal cancer is now the leading cause of death from cancer among Americans under the age of 50.
“Researchers found that the rate of colorectal cancer-related death among people younger than 50 years old has continued to increase by about one percent each year since 2005, while cancer-related death rates from all the other leading causes of cancer death have steadily decreased over the same time,” explains Dr. Chung. “As a result, colorectal cancer is now the leading cause of cancer death among young people, up from the fifth leading cause in 2005.”
Will this new research change screening guidelines even further
With screening now recommended starting at age 45, just below the age group where colorectal cancer rates are rising, you may be wondering whether this new research could influence future screening guidelines.
“Unfortunately, this study is unlikely to directly change official screening guidelines, in part because guidelines were already updated relatively recently,” says Dr. Lee-Kong. “In 2021, the U.S. Preventive Services Task Force lowered the recommended screening age for colon cancer from 50 to 45. However, this study provides essential validation that the earlier screening recommendation was necessary and timely.”
“This study, which looked at trends at a population level, is certainly a call to action to further investigate the rising rates of colorectal cancer death among younger people,” adds Dr. Chung. “However, we don’t have sufficient data from this study alone to determine the best screening strategy at this time.”
3 ways to lower colon cancer risk
Whether you have already been screened or are waiting until you are eligible, Dr. Chung offers three simple strategies to help lower your risk:
Limit alcohol and quit smoking
“Quit smoking and reduce alcohol to no more than two drinks a day for men and one drink for women, though no amount of alcohol is considered safe,” says Dr. Chung. “Both smoking and alcohol are toxins to your body that can damage DNA and turn healthy cells into cancerous cells.”
Boost your fiber intake
“Aim to consume at least 38 grams of fiber a day for men and 25 grams of fiber a day for women, preferably in the form of minimally processed whole foods [such as] fruits, vegetables and whole grains, rather than supplements,” says Dr. Chung. “Fiber has numerous benefits in the colon. It helps to feed the beneficial gut bacteria, which in turn produce protective substances for the colon cells, it reduces inflammation and helps you to eliminate waste and toxins from the body faster.”
Get moving
“Guidelines recommend engaging in moderate intensity exercise for at least 30 minutes daily, but you can also find ways to stay physically active throughout the day,” says Dr. Chung. “Park at the far end of the lot, use the stairs as much as you can or walk with your spouse or friend on your lunch break.”
The idea of developing any cancer, including colon cancer, can be anxiety-producing, but getting screened when eligible and making simple lifestyle changes can go a long way toward protecting your health and keeping you around for the people you love.
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