Yes, you: Colon cancer screening and prevention

Colorectal cancer is the second-highest cause of cancer death in the U.S., reports the CDC. Colorectal cancer is most frequently diagnosed between the ages of 65-74. But colon cancer in people aged 40- 49 has increased significantly over the past 20 years, now accounting for more than 10% of new cases.

Screening

Colon cancer screening should begin at age 45, recommends the U.S. Preventive Services Task Force, an independent panel of experts in disease prevention and evidence-based medicine. The task force recently updated its screening guidelines to include ages 45-49.

“Early discovery of cancer is the key to successful treatment and long-term survival,” says surgeon Katya Ericson MD, who performs endoscopy and colon cancer surgery at NH+C. Age-related screenings are key. Plus, “symptoms like blood in your stool, sudden changes in bowel habits or anemia should trigger a conversation with your medical provider” at any age.

A standard colonoscopy is recommended for most people. Your provider can help you determine whether you would benefit instead from a stool-based test like Cologuard, a fecal occult blood test (gFOBT), or fecal immunochemical test (FIT); or a visual test like a CT colonography scan.

“Colonoscopy is the best screening tool. It is a very low-risk procedure with the advantage of allowing us to remove polyps for pathological examination,” says Dr. Randolph Reister, an internal medicine specialist who performs as many as 400 colonoscopies each year. “A positive test result with one of the other methods will almost always lead to a colonoscopy as the follow-up. Ultimately, the best screening test is the one that gets done.”

More than 40% of people age 50+ have precancerous polyps in the colon, reports the American Society for Gastrointestinal Endoscopy (ASGE).

A minority of polyps removed during colonoscopy are found to be cancerous. The benefit of removing polyps is to prevent them from becoming cancerous.

“Any polyps or other material we remove during a colonoscopy is sent to the lab for biopsy,” says Dr. Ericson. “We usually know what we are dealing with very quickly.”

Steps to lower your risk of developing colon cancer

There are some risk factors you can’t control: heredity, family history, personal history of polyps, and conditions like inflammatory bowel disease. These factors are used to determine the frequency of screening, so any cancer is caught early.

Risk factors you can control include obesity, diabetes, diet (especially over-consumption of red meat and processed meats), smoking, and excessive alcohol use.

“The key is moderation,” notes Dr. Reister. “The elements of a healthy lifestyle – a balanced diet, physical activity, not smoking, and moderate alcohol consumption if you drink – are also good building blocks for lowering your risk of colon cancer.”

The best colon cancer screening begins early and is repeated at regular intervals. The main thing to remember is that early colon cancer screening – particularly colonoscopy – has a strong ratio of risk to reward: early detection and treatment, and a much better chance of survival and good health.

Colonoscopy Findings During Testing

The results of a colonoscopy generally fall into three categories:

• Normal, or with a benign finding such as hemorrhoids or diverticular disease: 10 year follow up
• Small polyps left in place (found 25-30% of the time): depending on size and number of polyps, 3-7 year follow up
• Cancerous mass detected (found 1-2% of the time): to be discussed with your provider for immediate follow-up treatment