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Colon Cancer

Colon cancer (also called colorectal cancer) is the second-leading cause of cancer death in New York City, after lung cancer. It is most often found in people aged 45 and older.

Each year in NYC, more than a thousand deaths on average are attributed to colon cancer and more than 3,400 new cases of colon cancer are diagnosed. Colon cancer affects men and women of all racial and ethnic groups. From 2015 to 2019, Black and White New Yorkers had higher death rates (13.8 and 10.7 deaths per 100,000 people, respectively) than Latinos (8.9) and Asian Americans and Pacific Islanders (7.8).

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Risk Factors and Prevention

Risk Factors

You are more likely to get colon cancer if you:

Are older (the older you get, the higher your risk)
Had colon cancer or polyps previously, or if you have a family history of colon cancer
Have certain inherited risks, such as familial adenomatous polyposis or Lynch syndrome
Have ulcerative colitis or Crohn's disease
Do not exercise regularly
Have obesity
Drink alcohol
Smoke

Know your risk factors and, where possible, try to address them.

Reduce Your Risk

To lower your risk of colon cancer:

Maintain a healthy weight
Eat fewer processed meats, such as hot dogs and deli meats
If you smoke, make a plan to quit
Exercise regularly
Reduce the amount and how often you drink alcohol

Screening

Screening Options

Routine screenings can prevent colon cancer or help find it early, when it is easier to treat. There are several different types of screenings. Ask your provider about which option might be right for you.

Colonoscopy

A colonoscopy involves a small tube with a camera being put inside your colon and rectum. It requires a special diet the day before and medication to clean out the colon. A colonoscopy can both detect cancer and remove polyps — small growths that may develop into cancer if left alone. A colonoscopy has a low risk for complications and is usually painless.

Stool-Based Test

Stool-based tests can be done at home by collecting a stool (feces) sample using a test kit and sending the kit to a lab. This test requires little or no preparation and has no health risk. If the result is abnormal, you will need a follow-up colonoscopy.

Steps for Screening

Talk to your health care provider about your risk of colon cancer. Many people should start screening at age 45. You may need to start earlier if you are at increased risk, for example, due to colon cancer in your family, or if you have ulcerative colitis or Crohn’s disease.
Ask about your screening options and discuss the risks and benefits.
Work with your provider to be sure your insurance covers the test you choose.
Schedule and complete your colon cancer screening test.
Keep up with screening according to one of the following recommended intervals:

Colonoscopy (PDF) every 10 years
Stool-based test with High-sensitivity Guaiac-based Fecal Occult Blood Test (HSgFOBT) (PDF) or Fecal Immunochemical Test (FIT) (PDF) every year
Stool-based test with Multi-target Stool DNA Test (FIT-DNA) (PDF) every 3 years

If you have an abnormal test result, follow your provider’s advice for next steps.

Payment

Most insurance plans, including Medicaid and Medicare, cover colon cancer screenings. However, coverage can vary. Consult with your health care provider and insurer about coverage before your screening test.

If you do not have insurance, you may be eligible to sign up for low- or no-cost coverage. Call 311 for free enrollment assistance. You can also get free assistance signing up for a plan.

If you cannot get insurance, or if your insurance does not cover screening, you have options. Call 311 to be connected to a New York City Health + Hospitals location and find out if you qualify for low-cost or no-cost colon cancer screening. You can also contact the New York State Cancer Services Program, which provides colon cancer screening to uninsured New Yorkers ages 45 to 75.

Health Education Materials

Choosing a Colon Cancer Screening Test

Learn about colon cancer prevention with the graphic novella, Choosing a Colon Cancer Screening Test: Mark's Decision. Read how Mark chooses between an at-home stool test and a colonoscopy, and how Mark and his family take steps to lower their risk of colon cancer.

Choosing a Colon Cancer Screening Test: Mark's Decision (PDF)

Learn more from these additional materials on colon cancer screening:

How To Do an At-Home Colon Cancer Test (PDF)
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Preparing for a Colonoscopy

Learn how to get ready for a colonoscopy with the graphic novella, Preparing for a Colonoscopy: Sandra’s Story. Read how Sandra prepares for a colonoscopy by consuming a liquid diet, avoiding opaque liquids and arranging for someone to pick her up after the surgery.