Over the past two decades, there have been several advancements in colon and rectal cancer treatments. However, a big part of successful treatment is detecting colorectal cancer earlier. Unfortunately, as with many other cancers, colorectal cancer doesn’t always come with obvious signs and symptoms until it’s too late. This is why it’s important to understand your family history and talk with your primary care physician about scheduling regular colorectal cancer screening.
Even if you’re feeling fine, we at Rocky Mountain Cancer Centers (RMCC) recommend that you follow the guidelines set in place by the American Cancer Society, which is to be screened starting at age 45.
Fortunately, there are several screening tests for colon and rectal cancers, including some that were recently made widely available. In addition to detecting colorectal cancer when it is present, regular screening can also prevent it by allowing your doctor to find and remove polyps before they have a chance to turn into cancer. To stay on top of your health, we recommend you take time to schedule an appointment with your primary care physician so you can learn more about your colon cancer screening options.
When it comes to screening, you have six main options to choose from. These tests range from those that are performed at a healthcare facility to those that can be conducted at home. Keep in mind that even though at-home testing offers more privacy, they can often lead to a false positive or a misinterpretation of the results.
In general, the best method of screening depends on factors such as your age and risk for developing colon and rectal cancer. Talking with your doctor can help when it comes to making a decision on a screening test.
We understand that taking time out of your day to visit the doctor for screening can seem like a nuisance. But if you think about it, these types of screening are a great way for you to take control of your health. Your doctor can help you determine which one of the following on-site tests is the best one for you:
During a standard colonoscopy, a flexible lighted tube called a colonoscope is used. Inserted into the rectum, the colonoscope features a lens for viewing and a tool for removing tissue. Air is inserted into the rectum, helping doctors to better view the colon lining. If any abnormal growths are identified, they can be removed for testing during this procedure.
A thorough cleansing of your colon prior to testing as well as being sedated during the test are two important steps that help contribute to a successful colonoscopy. According to the National Cancer Institute, studies show that colonoscopy screening can reduce colorectal cancer deaths as much as 60-70%. Because of this, colonoscopy is often the preferred screening test for early detection. A key benefit of a colonoscopy is the ability to view the entire colon.
With a virtual colonoscopy (or CT colonography) test, a CT scanner takes images of your colon. This test typically does not require sedation, however, it does require bowel preparation. During the test, air is pumped into your colon and rectum, which makes it possible for the scanner to show detailed, cross-sectional images. If the doctor sees polyps or possible cancer, a standard colonoscopy may be ordered for confirmation.
If you are at average risk for colon cancer and are age 50 and older, then you are an ideal candidate for a virtual colonoscopy. A doctor may also order a virtual colonoscopy if there is a bowel obstruction or you are at risk for complications from a regular colonoscopy.
Similar to a colonoscopy; however, this test looks only at part of your lower colon and rectum using a thin lighted tube-like instrument. In most cases, there is no need for sedation during a flexible sigmoidoscopy test. Doctors can either remove polyps during the test or order a colonoscopy. Although bowel preparation is necessary, it is not as extensive as that required for a colonoscopy.
It’s understandable that at-home colorectal cancer screenings have a certain appeal. But, as mentioned earlier, they are not always as accurate as the tests listed above. It’s important to note that these tests can miss many polyps and some cancers.
If you still prefer the comfort and privacy of your own home, you might want to ask your doctor about which test, if any, is right for you:
If you’d like to avoid the preparation and invasive testing of a colonoscopy, you can request a stool DNA test. Once you have the take-home test kit provided by your doctor, you will collect a stool sample and mail it to a lab. The test checks for blood in the stool and gene changes.
Although stool DNA tests are convenient and non-invasive, they are not for everyone. This type of testing should be reserved for only those with an average risk for colon or rectal cancer. If the test results are abnormal, additional testing through colonoscopy may be needed.
Another test that can be picked up from your doctor and taken home, is the guaiac-based fecal occult blood test (gFBOT). After you collect a stool sample onto a test card, you will return the card back to the doctor’s office for testing. Because tiny amounts of blood can go unseen by the naked eye, high-sensitivity blood tests, such as the gFBOT, can be an incredibly valuable screening tool.
gFBOT uses a chemical to detect heme, a component of the blood protein hemoglobin. Since this test may detect heme in certain foods and medications, such as red meat, you will most likely be required to eat a special diet prior to screening.
A fecal immunochemical test (FIT) is very similar to the gFBOT, and it uses antibodies to specifically detect human hemoglobin protein. However, unlike the gFBOT, there are no dietary restrictions prior to testing.
Recently, the American Cancer Society (ACS) lowered the recommended screening age from 50 to 45 for colon and rectal cancer. This new recommended age resulted from research that found increasing cases of this type of cancer among younger adults. Research remains ongoing, however, several contributing factors attributed to the increase are poor diets, lack of physical activity, and obesity.
In general, screening recommendations for colon and rectal cancer differ based upon whether you are at average risk or high risk for the disease. Patients who are at average risk tend to have no family history of colorectal cancer and are, on average, fairly healthy. The ACS recommends average-risk patients undergo a thorough screening every ten years.
If you fall into the high-risk category, the ACS recommends beginning screening earlier than age 45 and scheduling screenings more frequently than every 10 years. Prevention is key and especially important for those at high risk of developing colon or rectal cancer.
Before a doctor can diagnose colon or rectal cancer, further testing is often required. When any test other than a colonoscopy indicates abnormalities, a doctor may order a colonoscopy in order to view the colon in its entirety.
If pathology testing of polyps removed during a colonoscopy returns a cancer diagnosis, your doctor will work to stage the cancer. Discovering whether the cancer has spread helps a doctor to determine the stage.
It is important to remember that not all polyps are cancer. Before jumping to conclusions, wait to hear from your doctor.
When the time comes for treatment, RMCC is here to help. Our highly experienced oncology professionals are standing by to help treat colon and rectal cancer with a treatment plan designed specifically for you.