Colorectal cancer, or cancer in the colon and/or rectum, is the third most common cancer in the U.S. and the second leading cause of cancer death. But colorectal cancer is also one of the most preventable cancers with proper screenings.
“Most cases of colorectal cancer arise from an intermediary asymptomatic precancerous polyp,” said John Eastone, MD, gastroenterologist with HIMG, an outpatient facility of St. Mary’s Medical Center. “Identifying and removing the precancerous polyps before they have the chance to transition to cancer can and does prevent most cases of colorectal cancer.”
The American Cancer Society (ACS) now recommends that people at average risk for colorectal cancer begin screening at age 45, ﬁve years sooner than the ACS’ previous guidelines that called for screenings to begin at age 50.
“The incidence of colorectal cancer is rising in younger age groups,” Dr. Eastone said. “Screening at an earlier age should signiﬁcantly alter the grim diagnosis associated with colon cancer.”
The most well-known colorectal cancer screening is a colonoscopy. A colonoscopy is done using a colonoscope, which consists of a hollow tube with a light and video camera attached. The physician advances the scope through the entire colon, examining the walls for polyps. If polyps are found, they can be removed right then and sent to the laboratory for cell identiﬁcation, without undergoing a second procedure. If the colonoscopy reveals normal ﬁndings, a repeat exam is not usually required for 10 years, unless there is family history, a physician recommendation, or the onset of concerning bowel symptoms.
Because the colon must be cleansed prior to the colonoscopy, a bowel preparation is necessary the night before. That preparation often discourages people from following through with the procedure. So, Eastone encourages people to talk with their primary care provider about all of their screening options. “Colon cancer is treatable when detected early. A delay in diagnosis can be fatal,” he said. “If the difﬁculty of taking a preparation is what prevents a person from getting a colonoscopy, they should discuss one of the stool-based testing strategies with their provider.”
Those stool-based strategies include the fecal occult blood test (FIT test), which is done every year, or Cologuard, a stool DNA test done every three years.
Because the most common symptoms of colorectal cancer are no symptoms at all, Dr. Eastone stresses the importance of making a screening plan with your primary care provider. “Just do it. Talk to your doctor. Pick the strategy that works for you,” he said. “Don’t let unawareness of your options or fear of the test or results prevent you from getting screened.”
Colorectal Cancer Risk Factors
Screening for people at higher risk for colorectal cancer should begin before age 45. People at higher risk are those with:
• A strong family history of colorectal cancer or certain types of polyps
• A personal history of colorectal cancer or certain types of polyps
• A personal history of inﬂammatory bowel disease (ulcerative colitis or Crohn’s disease)
• A family history of hereditary syndrome such as familial adenomatous polyposis (FAP) or Lynch syndrome
• A history of radiation to the abdomen or pelvis to treat a prior cancer
For more information, or to schedule a colorectal cancer screening, contact:
HIMG Gastroenterology: 304.528.4660
Cabell Huntington Hospital Digestive Diseases Center: 304.691.1000
St. Mary’s Medical Center: 304.399.7667