Colorectal Cancer Screening Age 45: Why Doctors Lowered It and What to Do Now

# Colorectal Cancer Screening Age 45: Why Doctors Lowered It and What to Do Now

> **Quick answer:** Colorectal cancer cases have risen 51% in adults under 50 since the mid-1990s, making it the leading cancer killer in Americans under 50. In response, both the American Cancer Society and the U.S. Preventive Services Task Force lowered the recommended screening start age from 50 to 45 in 2021. For average-risk adults aged 45-75, colonoscopy and stool-based tests are fully covered by insurance at no cost. Catching it at an early stage gives a 91% five-year survival rate; waiting until symptoms appear often means late-stage diagnosis, where survival drops to 13%.

*This article is for informational purposes only and does not replace professional medical advice. Consult a qualified healthcare provider for decisions about colorectal cancer screening.*

Colorectal cancer under 50 screening age 45 is no longer a footnote in medical guidelines — it is the new standard of care, driven by one of the most striking trend reversals in modern oncology. While death rates from colorectal cancer have been falling in older Americans for decades, the opposite is happening in adults in their 30s and 40s. The question is no longer whether younger adults should be screened. The question is: why is so few of them actually doing it?

## Why Colorectal Cancer Is Rising in Adults Under 50

The numbers that forced the guideline change are stark. Since the mid-1990s, colorectal cancer incidence in adults under 50 has risen approximately 51%. In people aged 20-49, incidence is currently rising at roughly 3% per year, according to the American Cancer Society's *Colorectal Cancer Statistics 2026* report (lead author Rebecca L. Siegel, MPH, published March 2026 in *CA: A Cancer Journal for Clinicians*). Death rates in the under-50 group have risen about 1% per year since 2004.