We all want to grow older with good health and independence. That starts with taking care of ourselves—through healthy eating, regular movement, and meaningful connections with others. It also means being proactive about reducing our risk for chronic diseases like cancer.

One of the most prevalent cancers affecting older adults is colorectal cancer—the second leading cause of cancer-related deaths in the U.S. when numbers for men and women are combined.¹ In 2025, it’s estimated that 154,270 new cases of colorectal cancer will be diagnosed, and this disease will claim the lives of roughly 52,900 Americans.²

Despite the jarring statistics, there’s reason to be hopeful: When found early, colon cancer is highly treatable. In fact, the five-year survival rate for those diagnosed at an early stage (stage I-II) is about 91%.³

What is colorectal cancer?

Colorectal cancer, also called colon or rectal cancer, starts in the large intestine. It often begins as a small, usually harmless growth called a polyp, which can become cancerous over time. This cancer affects both men and women, most commonly adults over 50, though rates are rising in younger adults.

What are the stages of colorectal cancer?

• Stage 0: Cancer is only in the innermost lining.
• Stage I: Grows into the colon wall, no spread to lymph nodes.
• Stage II: Extends through the wall, lymph nodes unaffected.
• Stage III: Spread to nearby lymph nodes.
• Stage IV: Spread to distant organs like the liver or lungs.

Early detection through awareness of symptoms and regular screening greatly improves treatment success.

What are the warning signs of colorectal cancer?

In its early stages, colorectal cancer may not produce any noticeable symptoms at all. Or symptoms may be subtle and easily attributed to other issues such as stress and anxiety or hemorrhoids.

If you’re experiencing any of the signs below—even if you think they’re caused by something else—be sure to tell your health care provider:

• Blood in your stool, making it appear dark brown or black
• Persistent feeling of needing a bowel movement that does not resolve after having one
• Stomach pain, cramps, or gas
• Rectal bleeding (bright red blood)
• A change in stool shape or bowel habits (e.g., constipation, diarrhea) that lasts more than a few days
• Unexplained weight loss
• Fatigue and weakness

Since initial colorectal cancer symptoms can be overlooked, regular screening plays an essential role.

Why is screening for colorectal cancer so important?

Screening can detect colon or rectal cancer before symptoms appear—or even catch it in the pre-cancerous polyp stage. When cancer is found in these early stages, the chances of successful treatment go up dramatically.

Beyond saving lives, screening for colorectal cancer can also mean simpler, less invasive treatment. The main treatment for early stages of this disease is surgery, when cancer or polyps are removed. Most surgeries (especially for Stage 0 and Stage I) can be done through a colonoscopy, which eliminates the need for an abdominal incision. Later stages may involve not only surgery, but also chemotherapy, radiation, or a combination of these.

Who should get screened for colorectal cancer?

The American Cancer Society advises adults to begin regular screening for colorectal cancer at age 45 through age 75. If you're over 75, talk to your doctor. They can help you decide whether continued screening makes sense based on your health and screening history.

Earlier or more frequent screenings are recommended if you have one or more of the risk factors below:

• You've had (or have a family history of) colon or rectal cancer or adenomatous polyps.
• You have (or have a family history of) an inherited condition like Lynch syndrome or familial adenomatous polyposis (FAP).
• You have a condition like Crohn’s disease or ulcerative colitis that causes long-term inflammation in your colon.
• You’ve had radiation treatment to your belly or pelvis for another kind of cancer.

If any of these situations apply to you, be sure to tell your provider.

How can people get screened, and what are some of the newest options available?

There are several colorectal cancer screening methods used today for those who are average-risk, including a couple of new options that were approved by the U.S. Food and Drug Administration (FDA) as recently as last year. Here are the five main screening types and the benefits and drawbacks of each method:

Colonoscopy

During a colonoscopy, a doctor looks at the inside of your entire large intestine using a long, flexible, tube-like instrument with a camera. This is considered the “gold standard” screening method for colorectal cancer.

Pros:

• Checks the entire colon
• Can remove or biopsy polyps during the test
• Only needed every 10 years for average-risk individuals
• Could detect other health problems

Cons:

• Requires full bowel prep
• Sedation is usually needed (you’ll need a driver)
• May require time off work
• Higher cost if you’re uninsured
• Small risk of bleeding, infection, or bowel injury

Blood-based screening (e.g., Shield™ test)

This FDA-approved and Medicare-covered blood test can detect signals for colon cancer from DNA that’s been shed into the blood.

Pros:

• Only a simple and quick blood draw required
• No handling of stool involved
• Can be done as part of a regular doctor’s visit
• No bowel prep or time off work needed
• No pre-test diet or medication changes required
• No risk to the colon
• A colonoscopy is only needed if results are abnormal

Cons:

• May miss some polyps or cancers
• Insurance coverage may vary
• Should be repeated every 3 years

Stool-based test

Stool-based tests detect hidden blood, altered DNA, or RNA markers in your stool that can indicate the presence of polyps or cancer. They include FIT (fecal immunochemical test), gFOBT (guaiac-based fecal occult blood test), Cologuard (DNA-based), and ColoSense (RNA-based).

Pros:

• No direct risk to the colon
• No bowel prep needed
• Sample collected at home
• A colonoscopy is only needed if results are abnormal

Cons:

• May miss many polyps and some cancers
• Can give false-positive results
• Must be done every 1-3 years
• gFOBT only: Requires changes to diet (and possibly medication) before testing

Virtual colonoscopy (CT colonography)

This test uses a series of X-rays (computed tomography) to create detailed images of your colon that can reveal polyps and other abnormalities.

Pros:

• Non-invasive, quick, and generally safe
• Examines the whole colon
• No sedation needed
• Only needed every 5 years
• A colonoscopy is only needed if results are abnormal

Cons:

• Can miss small polyps
• Requires full bowel prep
• Can give false-positive results
• Involves a small amount of radiation
• Can’t remove polyps during the test

Flexible sigmoidoscopy

A doctor looks at the lower part of your large intestine using a thin, flexible tube with a camera.

Pros:

• Quick and generally safe
• No sedation needed
• Only done every 5 years
• A colonoscopy is only needed if results are abnormal

Cons:

• Not commonly used for screening
• May still require bowel prep
• Only checks the lower part of the colon, leaving much of it unscreened
• May miss small polyps or cancer
• Can’t remove all types of polyps
• May cause some discomfort
• Small risk of bleeding, infection, or bowel tear

“When it comes to which test to choose for colorectal cancer screening, the choice is personal,” says Craig Eagle MD, Chief Medical Officer of Guardant Health. “This is a decision people should make based on their risk level, lifestyle needs and preferences, and the advice of their doctor."

The most important thing is to choose a screening method and follow through with it. And with more screening options than ever before, the hope is that we can meet more people where they are, in a way that works for them, and really help make that happen,” Eagle said.

Take charge of your health: Schedule your colorectal cancer screening today

If you’re not getting regular colorectal cancer screenings, it’s not too late to start. Talking to your health care provider—and finding the screening option that’s right for you—is the first step to taking control of your colon health. It’s a good idea to bring a list of questions with you to your next appointment and take notes so you don’t forget any important details.

Note that not all colorectal cancer screening tests are covered by insurance, whether you have Medicare, Medicaid, or private health insurance. Before scheduling any tests, ask your plan provider what they cover and what out-of-pocket costs you can expect to pay.

Once you’ve explored your options with your doctor and made a decision, go ahead and schedule your screening. It's a small step that won’t take much of your time. And it could very well save your life.

Where can I find more information on colorectal cancer?

If you want to learn more about colorectal cancer or find support, check out the organizations below for helpful resources, advocacy, and personal stories:

• CDC Colorectal Cancer Resource
• USPSTF Recommendations for Colorectal Cancer Screening
• American Cancer Society
• Colon Cancer Coalition
• Fight Colorectal Cancer
• Colorectal Cancer Alliance

Sources

1. American Cancer Society. Key Statistics for Colorectal Cancer. Found on the internet at https://www.cancer.org/cancer/types/colon-rectal-cancer/about/key-statistics.html

2. NIH National Cancer Institute. Cancer Stat Facts: Colorectal Cancer. Found on the internet at https://seer.cancer.gov/statfacts/html/colorect.html

3. American Cancer Society. Survival Rates for Colorectal Cancer. Found on the internet at https://www.cancer.org/cancer/types/colon-rectal-cancer/detection-diagnosis-staging/survival-rates.html