Colorectal Health Awareness: Screening, Prevention, and Gut Health

Colorectal cancer is among the most common cancers in the United States and is highly treatable when found early. March is Colorectal Cancer Awareness Month, a useful moment for providers to review screening status with their patients.

Screening

U.S. guidelines generally recommend that average-risk adults begin colorectal cancer screening at age 45 and continue through at least age 75, with individualized decisions after that. Patients with a family history, inflammatory bowel disease, hereditary syndromes, or prior polyps may need earlier or more frequent screening.

Common Screening Options:

• Colonoscopy at guideline-based intervals
• Annual fecal immunochemical test (FIT) or high-sensitivity stool-based tests
• Multi-target stool DNA testing at recommended intervals
• CT colonography or flexible sigmoidoscopy in selected patients

Any positive non-colonoscopy screening test requires timely follow-up colonoscopy.

Symptoms That Warrant Evaluation

• Blood in the stool or rectal bleeding
• Persistent change in bowel habits
• Unexplained weight loss or iron deficiency anemia
• Persistent abdominal pain

These symptoms should not be attributed to benign causes without appropriate evaluation, at any age.

Modifiable Risk Factors

• Diet: Higher intake of fiber, vegetables, and whole grains; reduced processed and red meat
• Weight and metabolic health: Obesity and type 2 diabetes are associated with increased risk
• Physical activity: Regular activity is associated with lower risk
• Tobacco and alcohol: Both increase risk and should be addressed

Nutrition and Gut Health

Dietary fiber, adequate hydration, and a varied diet support bowel health. Some patients may benefit from targeted supplementation, such as vitamin D when deficient. Providers should base any supplement recommendation on individual need, and supplements do not replace screening.