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Colon cancer screenings: What to know about the life saving tests

Colorectal cancer is a major public health problem. It is the second leading cause of cancer death in the United States, behind lung cancer, and effects men and women equally. More than 130,000 adults are diagnosed with colorectal cancer annually, yet it is one of the most preventable types of cancer.

Most colorectal cancers develop from polyps, which are abnormal growths in the colon. If polyps grow unnoticed and are not removed, they can become cancerous. The development of more than 75-90 percent of colorectal cancer can be avoided through early detection and removal of pre-cancerous polyps.

Risk factors and symptoms

The likelihood of developing colon cancer in your lifetime is approximately 1 in 20. It is most common after the age of 50, but it can occur at younger ages. Risk factors for the development of colon cancer include a personal history of colon polyps or colorectal cancer, a strong family history of colorectal cancer, African-American race, obesity, cigarette smoking and excessive alcohol consumption.

Most early colorectal cancers produce no symptoms. This is why screening for colorectal cancer is so important. Some possible symptoms, listed below, do not always indicate the presence of colorectal cancer, but should prompt a visit with your physician:

  • New onset abdominal pain
  • Blood in or on the stool or a change in stool caliber or shape
  • A change in typical bowel habits, constipation, diarrhea

According to the American Cancer Society, the colon cancer death rate in this country could be cut in half if Americans followed recommended screening guidelines. Last year alone, more than 50,000 people died of colorectal cancer in the United States. Currently about 1 in 3 adults between 50 and 75 years old – about 23 million people – are not getting tested as recommended.

Screening basics

A colonoscopy every 10 years is the preferred colorectal cancer prevention test. For normal risk individuals, colonoscopy is recommended for those over age 50; however, African-Americans should begin screening at age 45.

Colonoscopy is a video examination of the colon. The video camera and the colonoscope, like any other video camera, cannot see through solids. Therefore, the colon must be thoroughly cleansed to provide the doctor the best opportunity possible for a thorough and detailed examination. This is often one of the less popular portions of undergoing colonoscopy, however, it is also one of the most important. Take the bowel preparation instructions seriously. Pick up the written instructions early, read them early, and follow them carefully.

When colonoscopy is done carefully and with an effective preparation, it is a very powerful cancer prevention technique.

Other possible screening tests for colorectal cancer include:

  • Tests for blood in the stool including, Fecal Immunochemical test (FIT), performed annually, and if results are positive, a colonoscopy is recommended. Also a combination test that includes a FIT test and a test for stool DNA to detect advanced colon polyps or colon cancer. Again if the test is positive, a colonoscopy is recommended.

  • CT Colonography, or “virtual colonoscopy,” is an X-ray designed to look for colon polyps and cancers. It is performed every 5 years. If polyps are detected, a colonoscopy is performed to remove these pre-cancerous growths.
  • Flexible sigmoidoscopy, which is similar to a colonoscopy but only, evaluates a portion of the colon.

Next steps

Please discuss colon cancer screening with your health care provider, and ask your friends and family to do the same. Remember, screening for colorectal cancer can save lives, but only if you get tested.

Dustin G. Case, DO, Mount Nittany Physician Group Gastroenterology, is the medical director of the gastrointestinal endoscopy unit at Mount Nittany Medical Center.
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