March Is Colorectal Cancer Awareness Month: What You Need to Know About Screening

Colorectal cancer is one of the most preventable cancers we face—and March is dedicated to raising awareness, improving screening rates, and making sure our communities have the information they need to stay healthy.

Over the last decade, experts noticed a troubling trend: people were being diagnosed with colorectal cancer at younger ages and with more advanced disease. Because of this shift, national guidelines changed.

Why the Screening Age Dropped From 50 to 45

For many years, routine screening for people at average risk began at age 50. But research showed:

• More adults in their 40s were being diagnosed

• Many were diagnosed at later stages

• Early detection dramatically improves outcomes

In response, major health organizations now recommend started screening at age 45 for average‑risk adults.

What If You Have a Higher Risk?

Some people may need to start screening earlier than 45.

You may be at higher risk if you have a first‑degree relative with colorectal cancer. A first‑degree relative means:

• A parent

• A sibling

• A child

These are your closest genetic relationships, and they carry the strongest impact on your personal risk. Depending on the age your relative was diagnosed, screening may be recommended earlier and more frequently.

Certain medical conditions—such as Crohn’s disease and Ulcerative Colitis—also increased risk and may require earlier or more frequent screening. Go to your trusted physician or provider like Libélula Primary Care to assess your personalized risk.

Women and BIPOC Communities Are Still Being Diagnosed Late

Despite years of education and outreach, women and BIPOC communities continue to have lower screening rates. Barriers include:

• Limited access

• Affordability

• Lack of culturally sensitive care

• Not knowing all the screening options

At Libélula, we believe in changing that—together. Preventive care should be accessible, respectful, and tailored to each person’s needs.

Your Screening Options: Stool Test, Colonoscopy, or Blood Test

There is no one “right” test for everyone. Here’s a simple breakdown:

1. Stool‑Based Tests (for average‑risk individuals)

These tests look for hidden blood or DNA changes in your stool.

Pros:

• Done at home

• No bowel prep

• Non‑invasive

Cons:

• Not as thorough as colonoscopy

• Must be repeated more often

• FIT is every year

• Cologuard is every 3 years

These are great options for people who want screening without the prep or sedation of a colonoscopy.

2. Colonoscopy (for high‑risk individuals or when stool tests are abnormal)

This is the most comprehensive test.

Pros:

• Allows doctors to find and remove polyps in the same procedure

• Only needed every 10 years if normal

Cons:

• Requires bowel prep

• Requires sedation and a driver

For people with higher risk—including family history—colonoscopy is the recommended test.

3. Blood Test (for average‑risk individuals)

A newer option done every 3 years.

Important note:

Many blood tests claim to screen for colorectal cancer, but only one is currently FDA‑approved for this purpose.

Blood tests are convenient, but they are still considered screening, not diagnosis. Any abnormal result must be followed by a colonoscopy.

Screening Tests Summary

Test	Description
Colonoscopy	Invasive rectal-colon camera visualization, screening but can be diagnostic and curative with biopsy Sensitivity for cancer is 95%, precancer high (>90%), Specificity 85-90% Highly Expensive Every 10 years, if normal
Shield	Screening blood test Sensitivity to cancer 84%, precancer 13%, Specificity 90%, if possible Highly Expensive Every 3 years, if positive, colonoscopy required after and thereafter
Cologuard	Screening stool test Sensitivity for cancer 92%, precancer 42%, Specificity 95% Moderately expensive Every 3 years, if positive, colonoscopy required after and thereafter
FIT / FOBT	Screening stool test Sensitivity for cancer 74%, precancer 24%, Specificity 94% Economical Every year, if positive, colonoscopy required after and thereafter

A Gentle Note: Screening Isn’t the Right Fit for Everyone

While screening saves lives, it’s also important to acknowledge—without stigma—that not everyone is a good candidate for colorectal cancer screening.

Some people may choose not to be screened because they would not want:

• A colonoscopy

• Surgery if cancer were found

• Treatment, including chemotherapy or radiation

Others may have medical conditions that make them too high‑risk to safely undergo procedures or treatment, and in those cases, screening may not align with their overall health goals.

At Libélula, we honor each person’s values, preferences, and quality‑of‑life priorities. Our role is to help you understand your options so you can make the decision that feels right for you.

How Libélula Can Help with Colorectal Cancer Awareness

Screening shouldn’t feel confusing or overwhelming. At Libélula, we help you:

• Understand your personal risk

• Choose the test that fits your life and your health needs

• Navigate insurance, pricing, and access

• Receive culturally sensitive, trauma‑informed care

March is the perfect time to take the next step. Early detection saves lives—and you deserve care that meets you where you are.

References

1. US Preventive Services Task Force. Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2021;325(19):1965‑1977.

2. American Cancer Society. Colorectal Cancer Facts & Figures 2023‑2025. American Cancer Society; 2023.

3. Siegel RL, Miller KD, Goding Sauer A, et al. Colorectal cancer statistics, 2020. CA Cancer J Clin. 2020;70(3):145‑164.

4. Centers for Disease Control and Prevention. Colorectal Cancer Screening Tests. CDC; 2024.

5. Rex DK, Boland CR, Dominitz JA, et al. Colorectal cancer screening: Recommendations for physicians and patients from the U.S. Multi‑Society Task Force on Colorectal Cancer. Gastroenterology. 2017;153(1):307‑323.

6. Ladabaum U, Mannalithara A, Meester RGS, Gupta S, Schoen RE. Cost‑effectiveness and national effects of initiating colorectal cancer screening for average‑risk persons at age 45 years instead of 50 years. Gastroenterology. 2019;157(1):137‑148.

7. Imperiale TF, Kahi CJ, Rex DK. Lowering the starting age for colorectal cancer screening to 45 years: Who will come…and should they. Clin Gastroenterol Hepatol. 2021;19(7):1232‑1234.

8. US Food and Drug Administration. FDA authorizes first blood test to help detect colorectal cancer. FDA; 2024.