Life begins at 40; colorectal cancer screening begins at 50

When Meryl Streep tells you to go get screened for colorectal cancer if you’re 50 years old or older, I’m afraid you don’t have a (Sophie’s) choice. Sure, you may have to have a tube Stuck On You – or rather in you – but as Mrs. Streep says – and she says more than One True Thing in this video – “for me, screening was simple and quick. It was no big deal, except for the huge sense of relief you feel afterwards.” Approximately 140,000 Americans are diagnosed with cancer of the colon or rectum every year. And while it is a preventable disease, it can trigger A Series of Unfortunate Events if left untreated. In fact, 50,000 people die from it a year, making it the second leading cancer killer in the United States. Mamma Mia!

“There are several tests that you can choose from,” Mrs. Streep says. If you’re in Doubt as to which to go for, “you should talk to your doctor. Decide which one is right for you.”

Colorectal Cancer Screening Tests




High-Sensitivity FOBT

·         One type of FOBT test involves placing a fecal sample on guaiac paper – which contains a chemical called alpha-guaiaconic acid – to check for invisible blood in feces.

·         The other type is the fecal immunochemical test (FIT), in which the patient is given a test kit by the doctor. At home the patient collects a small amount of stool with a stick or brush. The test kit is returned to the physician or a lab to be checked for the presence of blood. 

·         Once a year.

Flexible Sigmoidoscopy

·         A short, thin, flexible, lighted tube is inserted into the rectum to check for polyps or cancer in the rectum as well as in the lower third of the colon.

·         Every 5 years with FOBT every 3 years.


·         Similar to the above but with a longer, thin, flexible, lighted tube to find and possibly remove most polyps and some cancers not only in the rectum but also the entire colon.

·         May also be performed as a follow-up test should anything untoward be found in other tests.

·         Every 10 years.


·         Double-Contrast Barium Enema.

·         Virtual Colonoscopy.

·         Stool DNA Test.


Determining which tests is right for a given patient depends on that patient’s preferences, medical condition, likelihood to get a particular test, and the resources available for testing and follow-up. The U.S. Preventive Services Task Force (USPSTF) recommends screening for colorectal cancer with high-sensitivity fecal occult blood testing, sigmoidoscopy, or colonoscopy starting at age 50 and up until age 75. However, and even though over  90% of colorectal cancers occur in people aged 50 and older, some people may have to be screened earlier or more often, if they:

·         Have a close relative with colorectal polyps or colorectal cancer.

·         Have inflammatory bowel disease, Crohn’s disease, or ulcerative colitis.

·         Have a genetic syndrome like familial adenomatous polyposis (FAP) or hereditary non-polyposis colorectal cancer (Lynch syndrome).

Symptoms of colorectal cancer include blood in or on stool; persistent abdominal pain, aches, or cramps; and unexplained weight loss. But while “most colon cancers start as polyps,” as Mrs. Streep correctly points out, precancerous polyps and colorectal cancer don’t always cause symptoms, which makes screening for colorectal cancer all the more important. So remember; failing to get screened for cancer of the colon or rectum after turning 50 years old could be as bad a personal decision as starring in The Devil Wears Prada was a bad artistic decision for Meryl Streep.

Related: Can vitamin D fight colorectal cancer?