Saving lives with colorectal cancer screenings
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Saving lives with colorectal cancer screenings
Colorectal cancer is a leading cause of cancer death and is the third most common cancer diagnosed in both men and women in the US. It is estimated by the American Cancer Society that over 97,000 new cases of colon cancer and more than 43,000 cases of rectal cancer will be discovered in 2018.
Early detection and screening is one of the most effective ways to find and prevent colorectal cancer. Screening is the process of looking for cancer or pre-cancer in people who have no symptoms of the disease. Regular colorectal cancer screening is one of the most powerful weapons against colorectal cancer.
Advantages of colorectal screening
Screening can detect the early warning signs of colorectal cancer and can save lives. As with any cancer, the earlier they are caught, the greater likelihood of successful treatment. Colorectal cancer is no different as many colorectal cancers can be prevented through regular screening. Screening can find precancerous polyps which are abnormal growths in the colon or rectum. If any polyps are found during screening, they can be removed during the procedure before they turn into cancer.
Screening is crucial because when found early, colorectal cancer is highly treatable. When colorectal cancer is found at an early stage before it has spread, the 5-year relative survival rate is about 90%. But only about 4 out of 10 colorectal cancers are found at this early stage. When cancer has spread outside the colon or rectum, survival rates are lower.
Early stages of colorectal cancer usually present no symptoms, which tend to appear as the cancer progresses. Common symptoms indicating a possibility of colorectal cancer include blood in your stool, abdominal pain, change in bowel habits, and unexplained anemia or weight loss.
Six testing options available for colorectal cancer
Most of us assume the only way to screen for colorectal cancer is to have a colonoscopy. While no one looks forward to this procedure and the bowel prep that goes with it, colonoscopies do save lives. However, a colonoscopy is just one of many available screening tests to choose from:
This procedure uses a flexible lighted tube with a small camera on the end to look at the entire length of the colon and rectum. If polyps are found, they may be removed during the test. To prepare for the test, usually you need to follow special dietary restrictions for a day or two before the test. You will also be given a bowel prep with strong laxatives to clean out your colon. Generally, you will be sedated during the procedure. If nothing is found, you do not have to have another colonoscopy for 10 years.
· CT colonography or virtual colonoscopy
This procedure scans the colon and rectum taking detailed cross-sectional images for a doctor to review looking for polyps or cancer. A bowel prep is required, but no sedation. Air is pumped into the rectum and colon and then a CT scanner is used to take images of the colon. Anything suspicious found may be biopsied and a follow-up colonoscopy will be needed. CT colonscopy are done every 5 years.
This is a non-invasive test requiring no special diet or bowel preparation making it more appealing for those who do not want to undergo the preparation required for a colonoscopy. This test looks for certain gene changes that are sometimes found in colorectal cancer cells.
This testing uses a take-home kit that is supplied from a doctor’s office and is used to collect a stool sample which is then mailed to a lab. Cologuard is the name of the stool DNA kit that is currently FDA-approved. The test checks for DNA changes that could be a sign of cancer or pre-cancerous growths along with checking for blood in the stool.
This test is only for those with an average risk for colorectal cancer i.e., no personal history of pre-cancerous polyps, colorectal cancer or other factors.
Similar to a colonoscopy that may or may not use sedation, this test looks at only part of the colon and rectum. If polyps are found, they may be removed during the test and a colonoscopy will be necessary to look at the rest of the colon. A bowel prep is required but it is not as extensive as the one used for a colonoscopy. This test must be done every 5 years.
· Guaiac-based fecal occult blood test (gFOBT) and fecal immunochemical test (FIT)
These tests are a take-home test supplied by a doctor’s office used to find tiny amounts of blood in the stool, indicating a possible sign of cancer or larger polyps. If a person has a positive test, then they will need a colonoscopy also. One drawback to these tests is that many times the cause of blood found is often a non-cancerous condition, such as ulcers or hemorrhoids. Stool tests like these need to be done every year.
When to begin colorectal cancer screening
Recommendations from the American Cancer Society were recently released stating that American adults at average risk should begin colon cancer screening at age 45 instead of age 50. What influenced this change was a study published last year that found alarming rising rates of colon cancer and deaths in people younger than 50. Since 1994, there has been a 50 percent increase in cases of colon cancer in adults younger than age 50. At the same time, colorectal cancer rates have steadily declined in people over age 55 because of screening. If caught early, colon cancer is typically considered more treatable.
If you are 45 or older, talk to your doctor about which screening test is right for you. People, who are at a higher risk for colorectal cancer because of family history or certain health conditions, may need to start screening earlier than age 45.