Half of Americans Unaware of At-Home Colorectal Cancer Screening Options

Colorectal cancer is now the deadliest cancer for adults under 50, yet a new nationwide survey commissioned by the Colorectal Cancer Alliance reveals that 50% of Americans are unaware that colon cancer can be screened for at home.

The disease remains one of the most preventable since polyps detected and removed during screening can't turn into cancer later. This year, it is estimated that colorectal cancer will claim the lives of an estimated 55,000 Americans.

The online survey of 1,000 U.S. adults, conducted in November and December, found that 37% were unaware of all of the ways to screen for colon cancer, including colonoscopy, stool tests, blood tests, CT colonography and flexible sigmoidoscopy. More than 9 out of 10 survey respondents said they would be more apt to get screened if they knew it could prevent the disease.

An at-home colon screening involves collecting stool in the privacy of one's home and then dropping it off at a lab or clinic for analysis. It detects hidden blood or DNA in the sample. About 59% were unaware that a positive result on a non-invasive stool test calls for a follow-up colonoscopy to ensure a proper diagnosis.

The survey identified significant hurdles preventing people from getting checked. Cost and fear were the most common barriers, cited by around 48% of participants.

Younger people often struggle to have their health concerns taken seriously. One-third of respondents — and 45% of those under age 45, when screening should begin — said a doctor had dismissed their digestive symptoms. This dismissal gap is particularly dangerous because early-stage colon cancer often has no symptoms at all.

Overall, cancer death rates in people younger than 50 have dropped by 44% since 1990. But after increasing for decades, colorectal cancer is now the leading cause of cancer death in people under 50. Most colon cancer cases still occur in people over 50, but rates among people in their 20s, 30s or 40s have been climbing dramatically in the last few decades. Overall, 10% of colorectal cases are in people younger than 50.

Current medical guidelines recommend that adults with an average risk begin regular screening at age 45. The U.S. Preventive Services Task Force dropped the recommended age for colorectal cancer screening from 50 to 45 in 2021. Federal cancer screening guidelines and the American Cancer Society recommend that people who have an average risk for colorectal cancer should begin screening at age 45 with a colonoscopy every 10 years, or a stool test every one to three years.

The risk of colorectal cancer for someone ages 40-44 is about 21 per 100,000 people. That risk more than doubles from ages 45 to 49 — to 47 per 100,000 people — after routine screening is recommended.

As is, screening is already low among younger people who have an average risk. Only about 20% of people aged 44–49, who are universally eligible for colorectal cancer screening, are up to date.

People who have a family or personal history of colorectal cancer or polyps should start screening earlier than age 45. Those with risk factors — such as type 2 diabetes, Crohn's disease or a family history of the illness — should consult their doctor about starting even earlier.

Research has found that there are four distinct symptoms that can appear up to two years before a diagnosis: abdominal pain, rectal bleeding, ongoing diarrhea, and iron deficiency anemia. When warning signs like rectal bleeding, unexplained weight loss or persistent changes in bowel habits do appear, they require immediate attention, regardless of the patient's age.

Colorectal cancer often progresses without symptoms, but it is highly treatable with early detection and diagnosis. Colon cancer tends to be a slow growing disease which usually begins with growths, called adenomas or polyps, that can later turn into cancer.

Wakefield Research conducted the online survey and analysis.