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Colorectal Cancer: Why Screening at 45 Could Save Your Life
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Asia Tabb
Courtesy of iStock
AIRED; February 12, 2026
Listen to the podcast to hear the full conversation.
Colorectal cancer is one of the most common cancers in the United States — and one of the most preventable. That was the message shared by Dr. Sri Lakshmi Yeruva, a medical oncologist and hematologist with UPMC Hillman Cancer Center, during a recent interview on The Spark.
February is National Cancer Awareness Month, and this year’s conversations come amid renewed attention to the disease following the death of actor James Van Der Beek at age 48 after a diagnosis of stage three colon cancer. His story highlights what doctors say is a troubling trend: more younger adults are being diagnosed.
Colorectal cancer develops in the colon or rectum and often begins long before symptoms appear.
“Colorectal cancer is the malignancy arising in the colon and rectum,” Yeruva explained. “Most oftentimes, it begins as non-cancerous polyps.”
Polyps are small growths that form along the lining of the colon. While not all polyps become cancerous, some have what Yeruva describes as “malignant potential.”
“Usually, they take like 10 to 15 years’ time to develop into a cancer,” she said. “So, diagnosing them early on is very important.”
That long development window is precisely why screening is so effective. Doctors can identify and remove precancerous polyps before they turn into cancer.
“It is one of our most preventable cancers,” Yeruva emphasized. “We have a great tool to screen these patients early and diagnose them early, which is our colonoscopy.”
Colonoscopy remains the gold standard for colorectal cancer screening because it serves two critical functions: prevention and diagnosis.
“Colonoscopy serves us in two different ways,” Yeruva said. “One way… polyps can be picked that way, and the gastroenterologist can remove it right then and there.” Removing polyps significantly reduces the risk of cancer developing later.
The second benefit is early detection. “If there is a colon mass, and that is a cancerous lesion, we can diagnose them very early on and potentially resect them for possible cure,” she said.
Colorectal cancer is currently the third most commonly diagnosed cancer and the second leading cause of cancer-related deaths in the United States. More concerning, Yeruva says incidence rates are rising among younger adults.
“We are seeing increased incidence more into our younger adults,” she said. “So that is also why we need more information and spread of things that are available, early screening.”
In response to that trend, medical guidelines recently lowered the recommended age for average-risk adults to begin screening from 50 to 45.
“Initially it used to be 50, but within that timeframe, we are missing some potential polyps and then we are seeing the increased incidence,” Yeruva said. “Now all of the guidelines have lowered the threshold, and we are offering a screening colonoscopy for anyone with average risk at 45.”
One of the biggest misconceptions, she added, is that screening is only necessary if symptoms are present. In reality, early-stage colorectal cancer and precancerous polyps often cause no symptoms at all.
“When the polyps start initially, they don’t cause any problems. So, patients will be absolutely fine,” Yeruva explained. “Everyone will not develop symptoms until it’s later in the course.”
By the time symptoms such as rectal bleeding, changes in bowel habits, or unexplained weight loss appear, the disease may already be more advanced.
“We are missing that nice window where things are not causing problems and waiting until the problems hit,” she said. “But by then it might be already changed into a cancer.”
Despite its life-saving potential, many people still avoid colonoscopies out of fear, embarrassment, or concerns about preparation.
“There needs to be a lot of education,” Yeruva acknowledged. “Everyone gets nervous about the procedure.”
In the past, patients often dreaded the bowel preparation process. But she says that has improved significantly.
“Things have changed a lot,” Yeruva said. “There are flavored drinks they’re offering. Less amount of fluid that needs to be taken prior to the procedure. So the things have changed lately so much.”
She encourages patients to talk openly with their physicians about concerns and to weigh the short-term discomfort against the long-term benefits.
“We just have to educate, I guess, and explain the risk and benefits of this procedure and how helpful it would be,” she said.
For individuals who undergo a colonoscopy and have no polyps or high-risk findings, the test often does not need to be repeated for 10 years.
As National Cancer Awareness Month continues, Yeruva hopes more people will take proactive steps.
“It is one of our preventable cancers if diagnosed early and treated early,” she stressed.
For adults 45 and older — even those who feel perfectly healthy — that proactive step may begin with scheduling a screening.
