Preventive care is easiest to plan when you know which recommendations apply to you. For adults without symptoms, routine testing is different from an evaluation for a change in bowel habits, bleeding, or another concern.
Schedule a screening conversation with Eastside Bariatric & General Surgery in Snellville, or call 770-559-0778.
For average-risk adults, colorectal cancer screening usually begins at age 45. Options include stool-based tests completed at home and visual examinations such as colonoscopy; the right choice depends on your health history, preferences, and access to follow-up care. The U.S. Preventive Services Task Force recommends screening adults ages 45 through 75, while screening from 76 through 85 is individualized. A higher-risk history or symptoms may call for a different evaluation.
A screening consultation can clarify whether you are average risk, review the available test families, and explain what preparation and follow-up involve. It also helps separate routine prevention from diagnostic care, so the next step is based on your circumstances rather than a one-size-fits-all schedule.
When colorectal cancer screening usually starts
Colorectal cancer screening is a check for people who feel well. The Centers for Disease Control and Prevention describes a screening test as a way to look for disease when a person has no symptoms. If bleeding, a lasting change in bowel habits, or another symptom is already present, that is a diagnostic question, not a routine screening birthday.
Most colorectal cancers begin as polyps, which are abnormal growths in the colon or rectum. Screening can find some of those growths so they can be removed before they become cancer, and it can also find cancer earlier, when treatment is more likely to help. It does not guarantee that cancer will be prevented or found in every person.
For adults at average risk, current guidance puts the start earlier than the old "begin at 50" rule. The CDC says most people should begin colorectal cancer screening at age 45. The U.S. Preventive Services Task Force, in its May 18, 2021 recommendation, says to screen adults from 45 through 75. It gives a grade A recommendation for ages 50 to 75 and a grade B recommendation for ages 45 to 49. Those grades reflect how the Task Force judged the balance of benefit and harm, not a promise about any one person.
Average risk, in that Task Force statement, means an adult without symptoms and without a few specific histories. Those histories are prior colorectal cancer, adenomatous polyps, inflammatory bowel disease, or a known high-risk genetic disorder such as Lynch syndrome or familial adenomatous polyposis. If any of those apply, the age-45 start is only a reference point. The right time, and the right test, should be decided with a clinician who knows the history.
The practical takeaway for someone in Snellville or metro Atlanta is simple. If you are around 45 and have never been screened, it is reasonable to ask whether screening should start now. If you were told years ago to wait until 50, ask again, because the general recommendation has moved. The next sections cover who needs a different plan, which tests exist, and what a screening conversation actually involves.
How age and personal risk change the plan
The age-45 start is for people at average risk. Three other situations change the conversation, and none of them can be settled from a chart alone.
Ages 76 to 85
The U.S. Preventive Services Task Force says screening from 76 through 85 should be offered selectively. The net benefit of screening every adult in that range is small, so the decision rests on overall health, prior screening history, and what the person prefers. The American Cancer Society draws a similar line: adults in good health, with a life expectancy of more than 10 years, continue regular screening through age 75. From 76 through 85, health, life expectancy, prior screening, and preference all matter. The Society says people over 85 should no longer get colorectal cancer screening.
A person who has kept up with screening and now has serious other illnesses may reasonably stop. A person who has never been screened and is still well may have a different discussion. That is a clinical judgment, not a birthday rule.
A history that is not average risk
The CDC says some people may need to start before 45, or to be tested more often than the average-risk schedule. Reasons include inflammatory bowel disease such as Crohn's disease or ulcerative colitis. A personal or family history of colorectal cancer or polyps also counts, as does a genetic syndrome such as familial adenomatous polyposis or Lynch syndrome. The American Cancer Society adds two more reasons a person is not at average risk: a family history of colorectal cancer, and prior radiation to the abdomen or pelvis for another cancer.
Bring what you know to the visit: which relative was affected, their age at diagnosis, and whether anyone was told they had a hereditary syndrome. Do not assign yourself an earlier start date from a website. A first-degree relative diagnosed young is a different history from a distant relative diagnosed late in life, and the clinician has to sort that out.
Symptoms are not a screening delay
Screening is for people without symptoms. Rectal bleeding, a change in bowel habits that does not settle, unexplained weight loss, or abdominal pain that persists should be discussed as a diagnostic concern. Waiting for a 45th or 50th birthday is the wrong plan in that case. If the concern is a digestive problem rather than a routine check, the practice's page on general surgery and screening endoscopies is the place to see how a consultation is arranged. A finding that needs an operation is a separate decision from choosing a screening test.
Screening tests and what each one can show
Several tests can look for polyps or colorectal cancer. The best one is the test a person will complete, and that a clinician can follow up if the result is abnormal. The intervals below are the usual average-risk schedules from the CDC and the American Cancer Society. A personal history can shorten them.
| Test | Where it happens | Usual interval for average risk | If the result is abnormal |
|---|---|---|---|
| Fecal immunochemical test (FIT). | At home, with a small stool sample returned to a lab. | Every year. | Colonoscopy is needed to finish the evaluation. |
| Highly sensitive guaiac fecal occult blood test (gFOBT). | At home, with stool samples returned for testing. | Every year. | Colonoscopy is needed to finish the evaluation. |
| Stool DNA test with FIT (FIT-DNA or multi-target stool DNA). | At home. A whole bowel movement is sent to a lab. | Every 3 years. | Colonoscopy is needed to finish the evaluation. |
| Colonoscopy. | A procedure setting, with sedation in most cases. | About every 10 years if no increased risk is found. | Polyps can often be removed during the same exam. Follow-up depends on what is found. |
| CT colonography, also called virtual colonoscopy. | An imaging setting. | About every 5 years. | A colonoscopy is needed if the images show a concerning finding. |
| Flexible sigmoidoscopy. | A procedure setting. It views the lower portion of the colon. | About every 5 years. | A full colonoscopy is needed if an abnormality is found. |
The CDC is direct about follow-up. If a stool test, flexible sigmoidoscopy, or CT colonography is positive or abnormal, a colonoscopy is needed to complete screening. A normal home test is not the end of the story forever. It is one interval, and the next test still has to be planned.
Stool tests look for blood or, in the DNA tests, for altered DNA shed into the stool. They do not remove polyps. Colonoscopy uses a longer flexible tube to look through the rectum and the colon, and the doctor can remove most polyps during that exam. Sigmoidoscopy uses a shorter tube and does not see the whole colon. CT colonography uses imaging rather than a scope.
The American Cancer Society does not list blood tests among its preferred options. A blood test is less able to find precancerous growths, and a positive result still needs a colonoscopy. It is a fallback for someone who will not complete a stool test or a visual exam, not a first choice.
Eastside's screening endoscopy consultation is the place to discuss colonoscopy, and also upper endoscopy when that exam is the one being considered. The practice page does not offer every test in the table. Stool kits, CT colonography, and blood tests may be arranged elsewhere. A consultation can still help you decide whether colonoscopy is the right next step for your history.
What to expect before and after a screening visit
A screening visit at Eastside Bariatric & General Surgery starts with the reason for the exam, not with a generic instruction sheet. The practice's screening endoscopy page says a consultation connects that reason with your health history and the questions you want answered. The team then confirms which examination fits and what information is needed to plan it.
- Share your age, symptoms if any, and family history of colorectal cancer or polyps.
- Review which test fits that history, including whether a home kit is enough.
- Confirm preparation, medicines, and how an abnormal result would be followed up.
Bring a current medication list, relevant medical history, results from any earlier colonoscopy or stool test, and what you know about colorectal cancer or polyps in the family. If another clinician already ordered a test, bring that paperwork too. The visit is also the time to ask what an abnormal result would mean and how you would hear about it.
Preparation is specific to you
Bowel preparation, changes in what you eat, and which medicines to pause are not the same for every person. The care team provides preparation and follow-up instructions for the examination and the health history in front of them. Confirm those instructions with the team. A general article cannot tell you which prep to buy or which blood thinner to hold.
For colonoscopy, the CDC describes a longer flexible lighted tube used to look for polyps or cancer in the rectum and the entire colon. Most people receive sedation. During the test, the doctor can find and remove most polyps and some cancers. That is why colonoscopy can prevent some cancers, but it is not a guarantee, and it has uncommon risks such as bleeding or a tear in the bowel wall. Those risks belong in the consent conversation, weighed against the chance of finding something early.
After the exam
What happens next depends on what was found. A normal exam in an average-risk adult is often followed on a long interval. Polyps, a family history, or an incomplete view can shorten that interval. This article does not set that schedule. If you want the timing discussion after a prior exam, read how often a colonoscopy is repeated, then confirm the plan with the clinician who has your report.
If the screening test was a stool kit, a sigmoidoscopy, or CT colonography, an abnormal result is not a finished answer. The CDC says colonoscopy is still needed to complete the process. Ask, before you leave a consult, how soon that follow-up should happen and who arranges it.
Questions to bring to a Snellville screening consult
People come to a colorectal cancer screening visit with different gaps. Some have never been tested. Some had a colonoscopy years ago and are not sure it still counts. Some were handed a stool kit and never sent it back. A short list of questions keeps the visit on your history instead of a generic overview.
- Am I at average risk, or does my family history, inflammatory bowel disease, or a prior polyp change the start age?
- Is a stool test a reasonable first step for me, or does my history point toward colonoscopy?
- If a home test is abnormal, who arranges the colonoscopy and how soon should it happen?
- Which records should I send before the visit, and how does the office want to receive them?
- What symptoms would turn this from a screening plan into a diagnostic exam?
Cost and coverage are not the same for every plan, and a screening benefit can change if the test becomes diagnostic. Ask the office and your insurer before you assume a test is paid in full. The practice's page on financial options and insurance is the place to start that conversation. This article does not quote prices.
Most screening visits do not lead to surgery. If a finding does need an operation, that is a separate discussion about the procedure, the approach, and recovery. The practice's article on when a colon resection is considered explains that step. It is not the next page for someone who only needs to choose a screening test.
Dr. Aliu O. Sanni reviews the history at Eastside Bariatric & General Surgery. The practice sees patients from Snellville and the surrounding metro Atlanta area. Bring the questions above, even if you are not sure you are due. The useful outcome is a plan that matches your age and your history. It should not be a test chosen only because it was the first one you read about.
Frequently asked questions
At what age should colorectal cancer screening start?
For adults at average risk and without symptoms, the CDC and the U.S. Preventive Services Task Force say screening should start at age 45 and continue through age 75. A family history, prior polyps, inflammatory bowel disease, or a hereditary syndrome can move that start earlier. Ask a clinician before you use 45 as your own date.
What is the screening process for colorectal cancer?
You and a clinician choose a test that fits your risk and what you will actually complete. Home stool tests look for blood or altered DNA. Colonoscopy looks at the whole colon and can remove many polyps during the exam. An abnormal stool test, sigmoidoscopy, or CT colonography still needs a colonoscopy to finish the evaluation.
Can colorectal cancer screening be done with a kit at home?
Yes, for many average-risk adults. FIT and the older guaiac stool test are generally repeated every year. A stool DNA test combined with FIT is generally repeated every three years. A normal kit does not replace follow-up, and a positive kit should lead to colonoscopy rather than another home test.
Is there a blood test for colorectal cancer screening?
Blood tests exist, but the American Cancer Society does not list them as preferred screening options. They are less useful for finding precancerous polyps. A positive blood test still needs a colonoscopy, so a blood test is a fallback, not the first choice, for someone who will not do a stool test or a visual exam.
What if I already have symptoms?
Screening is for people who feel well. Rectal bleeding, a persistent change in bowel habits, unexplained weight loss, or ongoing abdominal pain should be evaluated as symptoms. Do not wait for a screening anniversary to mention them. Call the office and describe what you are noticing so the visit can be planned as a diagnostic question.
Talk with the Snellville team about screening
If you are approaching 45, overdue for a check, or unsure whether your history changes the plan, a conversation is more useful than guessing from a chart. Eastside Bariatric & General Surgery sees patients from Snellville and across metro Atlanta at 2085 McGee Road.
Contact the practice to discuss colorectal cancer screening, or call 770-559-0778. Bring your questions about timing, test choice, and any family history you already know.