Skip main navigation

Military Health System

Clear Your Browser Cache

This website has recently undergone changes. Users finding unexpected concerns may care to clear their browser's cache to ensure a seamless experience.

Colorectal Cancer Screening Age Decreases to 45

Image of A patient sits in an office with while a health care provider talks to her. U.S. Navy Cmdr. Candida Ferguson, a general surgeon at Naval Hospital Jacksonville, talks with a patient about colorectal cancer screening. The Defense Health Agency established new age recommendations for screenings. Regular screening with a stool test, sigmoidoscopy, or colonoscopy, beginning at age 45, is the key to preventing colorectal cancer and finding it early. (Photo: Deidre Smith, Naval Hospital Jacksonville)

Although the overall death rate from colorectal cancer has been on the decline in recent years, it remains the second leading cause of cancer deaths in the United States. There has also been an increase in colorectal cancer-related death for people younger than 55, and an increase in diagnosis in patients between the ages of 40-49 over the past decade, according to the National Cancer Institute.

With this new upwards trend, national health guidelines recently lowered the initial screening age from 50 to 45. This change means that an additional 21 million Americans will be eligible for screening.

In the Military Health System, the estimated impact of the lower age recommendation is that over 200,000 additional beneficiaries will need to be screened for CRC, according to Dr. Chin Hee Kim, deputy chief of specialty care support of the Defense Health Agency Directorate of Medical Affairs.

The new DHA guidelines also offer various CRC screening options, including expanding the use of a stool-based test known as Fecal Immunochemical Test, or FIT, as an alternative to a colonoscopy.

“Colorectal cancer screening, and preventive screenings in general, are important for overall wellness and healthy living. The MHS strives to implement evidence-based strategies to optimize both prevention and early detection of serious diseases before they become major,” Kim said. “Preventive care helps to sustain your health, meet standards for duty fitness, and maintain medical readiness.”

There is a 5-year survival rate of approximately 90%, if colorectal cancer is detected early.

When Should You Be Screened for Colorectal Cancer?

“Beginning at age 45, all average-risk men and women should undergo routine CRC screening,” said Kim.

Patients are considered to be at average risk if they:

  • Do not have a personal history of CRC or certain types of polyps.
  • Do not have a family history of CRC.
  • Do not have a personal history of inflammatory bowel disease.
  • Do not have a confirmed or suspected hereditary CRC syndrome.

According to Kim, CRC might not cause symptoms right away, but if you have one of these symptoms, you should see a doctor.

  • Rectal bleeding with bright red blood.
  • A change in bowel habits, such as diarrhea, constipation, or narrowing of the stool that lasts for more than a few days.
  • A feeling that you need to have a bowel movement that's not relieved by having one.
  • Blood in the stool, which might make the stool look dark brown or black.
  • Cramping or abdominal pain.
  • Unintended weight loss.

Kim said, “The screening method for CRC is based on shared decision making between the provider and the patient after discussing risks and benefits of all available screening options. A colonoscopy can be offered for both average risk and high-risk patients. The goal is to inform our beneficiaries about all screening options, including FIT, to optimize overall CRC screening for the MHS.”

Increasing Usage of FIT as a Tool

“While we have made great strides in colon cancer screening and prevention over the last several decades, around one-third of the U.S. population is not up-to-date on testing. By educating patients and providers about evidence-based alternatives to colonoscopy such as FIT, we are striving to expand access to screening to as many patients as we possibly can,” said U.S. Navy Lt. Brett Sadowski, program director of gastroenterology fellowship at the Navy Medicine Readiness and Training Command in San Diego.

Of the existing stool-based testing available, FIT is one of the most sensitive and cost-effective screening tests for colon cancer screening. The FIT is an easy to use, non-invasive, stool-based test that can be done at home.

The test must be done every year, but many people find them more convenient than other tests like a colonoscopy,” said Kim.

Instead of having to undergo an invasive procedure like a colonoscopy, one can collect their stool sample at home and mail it to the lab in provided packaging. Importantly, if a positive test result occurs, the patient should understand that a colonoscopy needs to be performed to complete the screening process. Like all screening tests, patients should be aware of following limitations of FIT, which include:

  • May miss tumors that bleed in small amounts or not at all.
  • Lower sensitivity to detect a potential pre-cancerous lesion in the colon.
  • Essential need to be repeated annually.

“The MHS is also working with clinicians to communicate and standardize workflow that incorporates the new age recommendation along with the appropriate use of FIT for average-risk patients. Medical logistics is also ensuring that FIT supplies are available at all military treatment facilities,” Kim said.

Lifestyle Changes Could Reduce Risks

Adopting healthy lifestyle habits can lower your risk of these types of cancer.

“Lifestyle factors play a profound role in our ability to impact our gut microbiome to support gut health. For all individuals, but especially for those who are at highest risk, lifestyle factors play an important role in reducing the risk of colorectal cancer,” U.S. Air Force Col. Mary A. Kiel, chief of the Air Force Medical Home Program at Air Force Medical Readiness Agency.

Along with a healthy diet, other “lifestyle factors such as reducing body weight, limiting alcohol, quitting smoking, and engaging in regular physical activity can have a profound positive impact on reducing risk,” said Kiel.

TRICARE Benefits

TRICARE covers colorectal cancer screenings for average-risk beneficiaries beginning at the age of 45 years old. It will cover the following types of screenings:

  • Fecal Immunochemical Testing: One stool sample once every 12-months.
  • Fecal Immunochemical Testing: Stool DNA tests once every 1-3 years.
  • Fecal Occult Blood Testing: Three consecutive stool samples once every 12 months.
  • Flexible sigmoidoscopy: Once every 5-years.
  • Optical colonoscopy: Once every 10 years.
  • Computed Tomographic Colonography: Once every 5 years.
  • Flexible Sigmoidoscopy: Every 10 years with FIT every year.

If you have concerns, need more information about colorectal cancer, or meet any of the screening guidelines, it is recommended you talk to your doctor.

You also may be interested in...

Article Around MHS
Nov 1, 2023

Walter Reed National Military Medical Center Champions Women's Health Care Options Using Minimally Invasive Hysterectomy Surgery

Dr. Candice Jones-Cox, the Women's Health Services director at Walter Reed National Military Medical Center is all smiles after becoming the first surgeon in the Department of Defense medical community to perform a robotic minimally invasive endoscopic surgery. (Photo by Ricardo Reyes/Department of Defense)

When you meet Dr. Candice Jones-Cox, director of the Women's Health Services at Walter Reed National Military Medical Center, you will learn that she's a fierce patient advocate and a meticulous surgeon, passionately learning cutting-edge techniques to adapt to an ever-changing medical landscape. She's an obstetrician-gynecologist, highly adept at ...

Article Around MHS
Oct 19, 2023

Lights, Camera, Ultrasound! Uniformed Services University Nursing Students Train Using High-Tech Simulation Theater

The Uniformed Services University students from the family and women’s health nurse practitioner program attended the university’s Wide-Area Virtual Environment at the Simulation Center for the first time in Oct. 2023. (Photo by Tom Balfour, USU)

Military students from the Uniformed Services University conducted immersive medical team training in the university's Wide-Area Virtual Environment. The theater is a a state-of-the-art 3D immersive reality facility that simulates various scenarios, replicating environments from war zones to medical emergencies, to prepare them for real-world medical ...

Video
Oct 18, 2023

The Importance of Mammograms

The Importance of Mammograms

Capt. Monica Lutgendorf, M.D. explains why it's important to get a mammogram, especially for individuals between the ages of 40 and 74. Breast cancer is the 2nd leading cause of cancer deaths among women. It's important to take time for your health and get your mammogram every other year if you are at normal risk. Contact your local hospital or clinic ...

Video
Oct 18, 2023

Schedule your Mammogram Screening Today

Schedule your Mammogram Screening Today

Capt. Monica Lutgendorf, M.D. explains the importance to get regular mammogram screenings. It's important to get screening for mammograms every other year for someone with normal risk factors. If you have higher risk factors, your screening recommendations may change. Please talk to your medical provider. You can schedule your mammogram at your local ...

Article Around MHS
Oct 6, 2023

U.S. Navy Capt. Brown’s Road to Excellence Leads to Inspire

U.S. Navy Capt. Cecilia Brown, a maxillofacial oral surgeon at Naval Hospital Jacksonville Dental Clinic, provides care for a patient. Brown, a native of Sparta, Georgia, is the first African American female to complete the U.S. Navy Oral and Maxillofacial Surgical Residency program and the only African American oral surgeon in the Navy. Brown says, “Life is like a 4-way stop.” (U.S. Navy photo by Deidre Smith, Naval Hospital Jacksonville/Released)

For Naval Hospital Jacksonville Director for Dental Services, U.S. Navy Capt. Cecilia Brown, demanding excellence amid adversity has been a charging force in her story of success. Brown is the first African American female to complete the U.S. Navy Oral and Maxillofacial Surgical Residency. This has also positioned her to be the only African American ...

Topic
Oct 4, 2023

Medical and Dental Preventive Care Fitness

Medical and Dental Preventive Care Fitness is your ability to sustain your health and wellness and facilitate restoration to meet medical and dental standards for fitness for duty, return to duty, and medical readiness.

Article Around MHS
Sep 29, 2023

Real Life Falls Are Not a Laughing Matter: Protect your Body, Ego

Each year thousands of military personnel injure themselves because of falls from vehicles and equipment, tripping over objects, and slipping on hazardous surfaces like ice, snow, or water. Injuries include lacerations requiring stitches, concussions or head injury, sprained ankles, wrists or hands, and broken bones. These often require ER visits and can result in temporary disability and lost duty time for many days or even months. (Defense Centers for Public Health-Aberdeen graphic illustration by Joyce Kopatch)

Cartoons typically portray slips or falls as comical accidents. But falls are no laughing matter. Falls often cause injuries that require emergency room visits for injuries such as lacerations requiring stitches, concussions or head injury, sprained ankles, wrists or hands, or broken bones. Learn how to prevent fall-related injuries.

Article Around MHS
Sep 11, 2023

A Profile in Courage: Former Marine Shares Her Breast Cancer Survivor Story

Stephanie Bowens, a former Marine, cancer survivor, and nursing administrator, contemplates her day at Walter Reed Military Medical Center, preparing for an upcoming breast reconstruction surgery. (Photo: Ricardo Reyes-Guevara, Walter Reed Military Medical Center)

Former Marine Stephanie Bowens stands quietly in the nerve center of Walter Reed Military Medical Center’s nurse administration office, gathering her thoughts before coordinating schedules, arranging meetings, and fostering camaraderie among her talented teammates. It’s the perfect position for a creative, energetic, and organized leader who ...

Article
Aug 23, 2023

TRICARE Laboratory Developed Tests Demonstration Extended, Certain Tests Now Covered

TRICARE Laboratory Developed Tests Demonstration Extended, Certain Tests Now Covered

The Defense Health Agency announced the five-year extension of the Laboratory Developed Tests Demonstration. The DHA extended the demonstration from July 19, 2023 through July 18, 2028. The DHA also announced that TRICARE will now cover several preconception and prenatal carrier screenings as part of the basic TRICARE benefit.

Article Around MHS
Aug 17, 2023

Breastfeeding Awareness Month Health Fair Big Hit for Bayne-Jones Army Community Hospital, Fort Johnson

Jesse Olson, aviation safety officer and certified child passenger safety technician at the Joint Readiness Training Center and Fort Johnson, Louisiana discussed the proper installation of and conducted a safety seat inspection for Nahomi Ortiz during the Breastfeeding Awareness Month family health fair August 5, at Bayne-Jones Army Community Hospital.  (Photo: Jean Graves)

Bayne-Jones Army Community Hospital hosted a Breastfeeding Awareness Month family health fair on Aug. 5, 2023, at the Joint Readiness Training Center and Fort Johnson, Louisiana. The event, coordinated by the BJACH Labor, Delivery and Post Partum ward and the OB/GYN clinic, was designed to give new and expectant parents an opportunity to learn about ...

Skip subpage navigation
Refine your search
Last Updated: July 11, 2023
Follow us on Instagram Follow us on LinkedIn Follow us on Facebook Follow us on X Follow us on YouTube Sign up on GovDelivery