Colon and Rectal Cancer

Colorectal cancer (CRC) screening looks for precancerous polyps and early cancers so they can be removed or treated sooner. For people at average risk, major guidelines recommend starting regular screening at age 45, continuing through 75, and using shared decision-making for ages 76–85; screening generally stops after 85. Options include stool-based tests (e.g., FIT) and visual exams (colonoscopy, CT colonography, flexible sigmoidoscopy). Choose the test you’re most likely to complete—any recommended method is better than none.

In 2024, the FDA also approved a blood-based screening test (Shield) for average-risk adults 45+. It can detect many cancers but does not find precancerous polyps well, so positive results still need a follow-up colonoscopy and negative results don’t replace routine screening.


Signs & Situations (When to consider testing)

Screen even without symptoms. Call your clinician promptly for rectal bleedingiron-deficiency anemia, a change in bowel habitsabdominal pain, or unintentional weight loss—these require diagnostic evaluation rather than routine screening.

Average risk (most adults): begin at 45; continue through 75individualize 76–85; generally stop after 85.

High risk (clinician-guided schedules): personal or strong family history of CRC/advanced polyps, inflammatory bowel disease, or hereditary syndromes (e.g., LynchFAP). These groups often start earlier and use colonoscopy more often.


Why These Tests Matter

What CRC screening can do

  • Prevents cancer by finding and removing polyps during colonoscopy.

  • Cuts deaths by finding cancer earlier—multiple strategies are effective when done on schedule.

What labs and markers cannot do

  • Blood tumor markers like CEA help monitor known CRC, not screen healthy people. They’re nonspecific and miss early disease; they should not replace screening.


What the Screening Tests Measure (at a glance)

Stool-based (home) tests

  • FIT or high-sensitivity gFOBT: detects hidden blood every year.

  • Stool DNA-FIT (sDNA-FIT): looks for blood and abnormal DNA every 1–3 years (often every 3 years in practice).
    All positive stool tests → diagnostic colonoscopy.

Visual (structural) exams

  • Colonoscopy: examines entire colon and removes polypsevery 10 years if normal.

  • CT colonography: every 5 years.

  • Flexible sigmoidoscopy: every 5 years (or every 10 with annual FIT).

Blood-based test (new option)

  • Shield (Guardant Health): FDA-approved for average-risk adults 45+; detects many cancers (CRC sensitivity ~83%specificity ~90%), but low sensitivity for advanced precancerous lesions (~13%). A positive result requires colonoscopynegative means stay on schedule with repeat screening.

Remember: The “best” test is the one you’ll complete—and repeat at the right interval.


How the Screening Process Works

  1. Pick a method with your clinician (FIT, sDNA-FIT, colonoscopy, CT colonography, sigmoidoscopy, or eligible blood test). Consider accuracy, prep, frequency, and your preferences.

  2. Complete the test: at home (stool) or scheduled procedure (colonoscopy/CTC/sigmoidoscopy) or blood draw(Shield).

  3. Get results quickly: stool and blood tests usually return within days; procedure-based results may include pathology timing.

  4. Follow through: any positive non-colonoscopy test requires colonoscopy to diagnose and remove polyps.


Interpreting Results (general guidance)

  • Negative FIT/sDNA-FIT: repeat at the recommended interval (typically 1 year for FIT; 1–3 years for sDNA-FIT).

  • Positive FIT or sDNA-FIT: schedule colonoscopy—this is part of the screening pathway.

  • Normal colonoscopy: repeat in 10 years (unless your clinician advises sooner based on findings/risk).

  • Shield blood test: positive → colonoscopynegative → continue screening per the test’s recommended interval and your clinician’s advice. Note the limited ability to detect precancerous polyps.

  • CEA or other tumor markers: not for screening; used under oncology care to track known CRC.

Always review results with a qualified healthcare professional.


Choosing a Strategy (panels vs. individual tests)

  • Average risk (45–75): pick one of the USPSTF-recommended options and stay on schedule (FIT yearly; sDNA-FIT q1–3y; colonoscopy q10y; CT colonography q5y; sigmoidoscopy q5y; or sigmoidoscopy q10y + annual FIT).

  • 76–85: discuss individual benefits/harms and prior screening history.

  • High risk: earlier and more frequent colonoscopy (clinician-directed).

  • If you decline stool or colonoscopy: an FDA-approved blood test (Shield) is now an option for average-risk adults 45+; understand its limits and the need for colonoscopy after a positive result.


FAQs

What’s the best screening test for colon cancer?
There isn’t one “best” test for everyone. USPSTF-recommended choices include stool tests and visual exams; the right choice balances accuracy, convenience, and your willingness to repeat it on time.

Is there a blood test for colorectal cancer?
Yes. Shield is FDA-approved for average-risk adults 45+. It detects many cancers but misses most precancerous polypspositive results need colonoscopy and negative results don’t replace routine screening.

Do tumor markers like CEA screen for colon cancer?
No. CEA is not recommended for screening; it’s mainly used to monitor known CRC under oncology care.

When can I stop screening?
Usually at 75 you reassess; 76–85 is individualized; stop after 85 in most people. Follow your clinician’s guidance.

If my stool test is positive, can I repeat it instead of a colonoscopy?
No. A positive non-colonoscopy test is followed by diagnostic colonoscopy to find and remove polyps.


Internal Links & Cross-References

  • Cancer Screening Hub

  • Men’s Cancer & Tumor Markers

  • Women’s Cancer & Tumor Markers

  • Multi-Cancer Early Detection (MCED)

  • Key Lab Tests: FIT • Stool DNA-FIT • CEA (monitoring) • Comprehensive Metabolic Panel (treatment context)


References 

  1. U.S. Preventive Services Task Force. Colorectal Cancer: Screening. Final Recommendation Statement. JAMA, May 18, 2021.

  2. American Cancer Society. American Cancer Society Guideline for Colorectal Cancer Screening. Last revised January 29, 2024.

  3. Centers for Disease Control and Prevention. Screening for Colorectal Cancer. Reviewed February 26, 2025.

  4. American College of Gastroenterology. ACG Clinical Guidelines: Colorectal Cancer Screening. 2021.

  5. U.S. Food and Drug Administration. Shield – P230009 (Guardant Health). Approval date July 26, 2024.

  6. Chung DC, et al. A Cell-free DNA Blood-Based Test for Colorectal Cancer Screening. New England Journal of Medicine. 2024.

  7. StatPearls. Carcinoembryonic Antigen (CEA). Updated 2024.

Available Tests & Panels

Tip: If you’re unsure where to start, FIT (annual) or colonoscopy (q10y) are common choices. 

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Blood
Blood Draw

The Fecal Globin by Immunochemistry Test detects hidden (occult) blood in stool using antibodies that identify human globin protein. This test helps screen for colorectal cancer, polyps, ulcers, and gastrointestinal bleeding. Doctors order it when patients have anemia, abdominal pain, or changes in bowel habits. Results provide early detection of digestive tract bleeding, guiding further evaluation with colonoscopy or other diagnostic procedures.

Varied
Phlebotomist
Also Known As: Fecal Immunochemical Test, Fecal Occult Blood Test, Stool Occult Blood Test, FIT Test, FOBT

Most Popular

The CA 19-9 Test measures levels of carbohydrate antigen 19-9 in blood, a tumor marker often elevated in pancreatic cancer and sometimes in bile duct, colorectal, or liver cancers. While not used alone for diagnosis, it helps monitor treatment, track disease progression, and detect recurrence. Elevated CA 19-9 may also occur in noncancerous conditions. Doctors use this test to support cancer management and guide therapy decisions.

Blood
Blood Draw
Also Known As: CA 19-9 Tumor Marker, Cancer Antigen 19-9 Test

Most Popular

The CEA Test measures carcinoembryonic antigen levels in blood, a protein that may be elevated in certain cancers, especially colorectal, pancreatic, lung, breast, or ovarian cancer. It is not used alone for diagnosis but helps monitor cancer treatment, detect recurrence, and track disease progression. Elevated CEA can also occur in noncancerous conditions. Doctors use this test to support therapy decisions and provide insight into cancer management.

Blood
Blood Draw
Also Known As: Carcinoembryonic Antigen Test

The DNA (ds) Antibody Test detects double-stranded DNA antibodies, often linked to systemic lupus erythematosus (SLE) and other autoimmune diseases. High levels may indicate lupus activity, kidney involvement, or autoimmune flare-ups. Doctors order this test for patients with joint pain, fatigue, rash, or suspected connective tissue disease. Results provide critical insight for diagnosing lupus, monitoring disease progression, and guiding treatment decisions.

Blood
Blood Draw

The Galectin-3 Test measures levels of galectin-3, a biomarker linked to heart failure, cardiac fibrosis, and inflammation. Elevated results may indicate worsening heart disease, increased risk of hospitalization, or progression of chronic conditions. Doctors use this blood test to assess heart health, guide treatment decisions, and monitor patients with heart failure, offering valuable insight into long-term cardiovascular risk and management.

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Blood Draw

Varied
Phlebotomist

The Trimethylamine N-Oxide (TMAO) Test measures TMAO levels in blood to assess cardiovascular and metabolic risk. TMAO is produced when gut bacteria metabolize nutrients like choline, carnitine, and betaine from foods such as red meat and eggs. Elevated levels are linked to heart disease, stroke, kidney dysfunction, and metabolic disorders. Doctors order this test to evaluate cardiovascular risk and guide lifestyle, diet, or treatment strategies.

Blood
Blood Draw
Also Known As: Trimethylamine N-Oxide Test

The UGT1A1 Gene Polymorphism (TA Repeat) Test detects variations in the promoter region of the UGT1A1 gene that affect bilirubin metabolism and drug clearance. This genetic test helps identify Gilbert syndrome and assess risk for adverse drug reactions, particularly with irinotecan and other UGT1A1-metabolized medications, guiding safe and personalized treatment strategies.

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Blood Draw

5 Benefits of Colorectal Screening Tests

Going to the doctor can be a source of anxiety, especially as you get older. With each passing year, it can seem like your doctor is adding on more screening tests. You might even be avoiding your doctor for this reason.

While exams and tests can seem excessive, they are extremely important for prevention. You might not have a certain health problem now, but knowing quickly if you do can expand treatment options and increase your chances of a long life.

If you're concerned about colorectal disease, including colorectal cancer, or you're worried about the screenings involved, this article is for you. Read on to learn about colorectal diseases, the benefits of getting tested, and what each screening involves.

What is Colorectal Cancer?

Colorectal cancer is the development of tumors in your colon or rectum, which sit at the lower end of your digestive tract. Like many other cancers, the early stages can often go without symptoms and detection.

Doctors can treat colorectal cancer and cure it easily when detected early. 

Colorectal cancer starts as small noncancerous polyps. If left alone, these polyps can grow, eventually causing symptoms.

Risk Factors for Colorectal Cancer

As with other types of cancer, certain groups of people are more likely to develop polyps. If you've already had occurrences of polyps or cancer, you are at a higher risk of developing it again. If not, there are some other risk factors to be aware of:

  • Heavy alcohol use
  • Heavy smoking
  • Obesity
  • Diabetes
  • Low-fiber, high-fat diets
  • Family history of colorectal cancer
  • Sedentary lifestyle
  • Inflammatory conditions in the intestines
  • Syndromes that increase colon cancer risk, like Lynch syndrome or familial adenomatous polyposis (FAP)
  • Being African-American
  • Being over the age of 50

If you fit one or more of these categories, you should be aware of your heightened risk.

Causes for Colorectal Cancer

Like other cancers, colorectal cancer doesn't have a proven cause. Doctors can only target similar traits of people who are at higher risk of developing colorectal cancer.

Cancer, in general, is caused by healthy cells developing mutations that result in uncapped growth. These tumors invade space that was not meant for the growth of these cells, pressing on healthy tissue. They can also break off and travel to other parts of your body, depositing the mutation elsewhere.

To help prevent the occurrence of colorectal cancer, you can choose to make some changes to your lifestyle:

  • Eating more of a variety, including fruits, grains, and vegetables
  • Stop smoking
  • Achieve or maintain a healthy weight
  • Exercise more
  • Reduce alcohol consumption

Following these simple lifestyle choices can not only help decrease your risk of colorectal cancer but most other diseases.

Signs and Symptoms of Colorectal Cancer

If your precancerous polyps have gone undetected, you might start experiencing symptoms. The type of symptoms and the severity can differ according to the location and size of your polyps or tumors.

You may notice:

  • Rectal bleeding or bloody stool
  • Never feeling like you've completely emptied yourself
  • Weight loss without explanation
  • Fatigue and extreme weakness
  • Constant discomfort in your abdomen
  • Sudden and persistent change in bowel habits

If you've noticed any of these changes, you should contact your doctor right away. They will issue some diagnostic tests to determine the cause.

5 Benefits of Colorectal Screening Tests

Before you ever have symptoms, doctors will recommend screening tests to find any early signs of colorectal issues. It is important to understand the distinction between screenings and diagnostic tests. Screenings are exams to check for issues without symptoms, while diagnostic tests check your health after symptoms arise.

There are many benefits to complying with your doctor's orders for screening tests or seeking them on your own regularly. Below are the five top benefits of colorectal screenings.

1. There are Many Different Options

You might worry about colorectal screenings because you've heard some bad stories about one type of exam. For example, many people dread the infamous colonoscopy. However, colonoscopies are usually done while sedated, so you won't need to experience discomfort during the test.

You might not always be able to avoid a specific test depending on your circumstances, but for many patients, there are a lot of options to keep up with screenings. Often, doctors recommend pairing one test with another to increase accuracy.

These tests include fecal tests, visual tests, and even blood tests.

2. Find Potential Issues Before the Symptoms

The best thing about screenings is that they happen before you have symptoms. While many doctor visits happen because of existing problems, screenings are stress-free with much less worry about results.

Colorectal cancer is infamous for being fatal if left alone, and yet it is highly treatable when caught early. Most people who develop colorectal cancer survive and fully recover because they were regularly screened and caught their disease early.

When you consent to colorectal screening, remember that you are doing your part in increasing your chances of a long healthy life. Additionally, you could catch your disease before you ever experience symptoms. You can catch and treat your cancer early without ever having experienced the negative health effects.

3. They Identify Colon Polyps

Colorectal screenings are mainly focused on identifying pre-cancerous polyps. If you are regularly screened, your doctor can identify polyps early before they grow and start to cause symptoms.

Despite popular belief, polyps are not the only signs of cancer. Many other lifestyle choices or diseases can cause polyps to form. This means that your doctor might be able to diagnose you with other diseases that aren't necessarily colorectal cancer.

Foods that are proven to cause colon polyps include processed meats such as lunch meat, sausage, hot dogs. Other foods include red meat and fatty, fried foods. Your doctor will ask you about your diet and advise that you change your eating habits.

Inflammatory diseases that affect the colon, including Crohn's disease, could also be a cause of polyps. Some women who have ovarian cancer can also develop polyps in their colorectal area.

Allowing your doctor to perform screenings means they might find polyps and run further tests to find the cause.

4. They Identify Occult Blood

Similar to identifying polyps, colorectal screenings can identify occult blood. If you take fecal exams, a screening will be able to find traces of blood. Occult blood is a sign of colorectal cancer, but can also be a sign of many other health conditions.

Other diseases or damage to your colon can cause your stool to have occult blood. These include:

  • Crohn's disease
  • Ulcers and fissures
  • Ulcerative colitis
  • Diverticular diseases

If your doctor sees occult blood in your results, they may request you undergo further tests to find the cause.

5. Start Treatment Early 

Undergoing colorectal screenings may uncover undesired results, but you shouldn't lose hope. Early detection of colorectal issues allows your doctor to start treatment early and dramatically increase your chances of full recovery. 

Early treatment means you'll likely have less intensive treatment. You'll be able to undergo smaller amounts of treatment for less time and get back to your life. 

Lab Tests for Colorectal Cancer

One screening for colorectal cancer is a Fecal Immunochemical Test (FIT). This test requires no bowel prep or change in diet or medications. You can perform it at home, and it's also fairly inexpensive.

The FIT is similar to the guiac-based fecal occult blood test, which tests for otherwise untraceable blood in the stool. You'll also not need to prep beforehand, and the test can be done at home. You will have to change your diet and medications, however.

Stool DNA tests are also widely available. These are easy to complete at home with no pre-test changes and no prep. These tests are fairly new, however, and might not be covered by insurance.

The ColoVantage® (Methylated Septin 9) is a blood test that requires no patient preparation and detects circulating methylated DNA from the SEPT9 gene, which is a marker associated with colorectal cancer.

Some more invasive tests are required less often but might include sedation and require pre-test prep and diet changes. These tests include colonoscopies, flexible sigmoidoscopies, and CT colonography.

FAQ'S

What is the survival rate of colorectal cancer?

If you are diagnosed with localized colorectal cancer, your chances of survival are 91%. If cancer has spread, your chances decrease to 72%. If the cancer has been in your body for 5 years, your chances are about 63%.

What are the signs of late-stage colon cancer?

Late-stage colon cancer, stage 3 and stage 4, are characterized by blood in the stool, constipation, and diarrhea. You can also experience fatigue, long and thin stools, pain and bloating, nausea and vomiting, and weight loss. If cancer has spread, it most commonly causes symptoms related to your lungs, liver, and abdomen.

When should I get checked for colon cancer?

Both women and men should start getting colorectal screenings at the age of 50 unless they have risk factors. If they have risk factors, their doctors will recommend earlier and more frequent screenings. The American Cancer Society now recommends starting at 45.

Benefits of Colorectal Lab Testing with Ulta Lab Tests

Ulta Lab Tests offers tests that are highly accurate and reliable so you can take control of your health by making informed decisions. Our tests are secure, include confidential results, are available without insurance or referrals, and are very affordable. They also come with a 100% satisfaction guarantee.

Order your colorectal cancer screening test today and your results will be provided to you securely and confidentially online in 24 to 48 hours for most tests. Take charge of your health and track your progress with Ulta Lab Tests!