Someone born around 1990 is now four times as likely to develop rectal cancer as someone born around 1950, according to one analysis.
"These tests work and they're safe", he says.
Colorectal cancer deaths are declining, but shocking disparities remain.
Other groups, including the independent and volunteer U.S. Preventative Services Task Force of specialists, maintain their recommendation that screenings start at 50. Judy Yee, chair of the ACR Colon Cancer Committee, in a statement. "Nobody knows why really clearly, and that's a big area of interest, but nobody's questioning that it's happening".
It's worth noting that overall case numbers still aren't high for people aged 20 to 49 - rates in that group went from 2.6 per 100,000 people to 5.2 cases. But the change is disconcerting.
A year ago colorectal cancer claimed more than 50,000 lives in the United States.
As the ACS researchers explained in the paper announcing the new screening guidelines, the rise in cases of colon and rectal cancers can not simply be explained by the fact that more cases are being found because screening is more common.
Doctors believe this could lead to more early detection, but there are other factors.
"We're deeply concerned about this trend", says Dr. Richard Wender of the American Cancer Society.
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One of those younger colorectal cancer patients is Lari Johnston of Chicago, who's now 50. Doctors also recommend stool blood tests, which are done every year.
But about a third of people over 50 never get screened.
The data that influenced the American Cancer Society found that the lower screening age would result in about a 6 percent increase in the benefit of screening and would require a 17 percent increase in colonoscopies.
The good news is that patient's don't necessarily need an invasive colonoscopy at 45, just the screening will suffice in order to see if further tests should be done. Annual test options include two types that can be done from home - for those, patients collect a stool sample and send it in to be tested.
If you are 45 or older, you should have a colonoscopy every 10 years.
Experts say it is unclear why colon cancer rates are on the rise in younger people.
With these new findings, she suggests people refer to their insurance company and doctor to find out when they should get screened.
Based on their review and that simulation modeling, the researchers identified efficient strategies for screening starting at age 45.
But he noted that younger people are also at increased risk.