Importance of Colorectal Cancer Screening

Colorectal cancer is the third most common cancer diagnosed in the United States. According to the American Cancer Society, approximately 106,100 new cases of colon cancer and 44,850 cases of rectal cancer are diagnosed per year. It affects approximately 65,000 women per year causing death in 40% of those diagnosed. However, this cancer is highly preventable if diagnosed at an early stage. Colorectal cancer tends to develop from precancerous polyps which are abnormal growths in either the rectum or colon. Screening tests are able to detect these polyps and can allow the physician to remove them before malignant transformation. There are several colorectal cancer screening techniques that exist and should be kept up with to prevent cancer progression.

The US Preventive Services Task Force recommends adults between the ages of 45-75 to be screened for colorectal cancer. Those between the ages of 76-85 should discuss screening with their primary care practitioner. Some patients may need to be screened before turning 45 if they have any of the following risk factors:

• Lynch syndrome

• Genetic syndrome (Familial Adenomatous Polyposis - FAP)

• Family history of colorectal cancer or polyps

• Personal history of colorectal cancer or polyps

• Crohn’s disease

• Ulcerative colitis

• History of inflammatory bowel disease

There are several types of colorectal screening tests: fecal occult blood test, sigmoidoscopy, colonoscopy, virtual colonoscopy or DNA stool test. A fecal occult blood test is performed by checking a patient’s stool for blood and viewing it under the microscope. Blood may indicate polyps or other important conditions and thus must be checked by the laboratory. To perform a sigmoidoscopy, a sigmoidoscope is placed into the rectum to get to the sigmoid colon to evaluate mucosa for polyps, abnormal growths or any cancerous signs. Similarly, a colonoscopy uses a colonoscope to evaluate the colon for polyps, abnormal growths or any cancer signs. A physician may also be able to remove any polyps or abnormal tissue growths to biopsy for signs of cancer. A virtual colonoscopy uses CT scans to create a cross sectional photo of the colon which the physician may visualize to note any abnormalities. Lastly, a DNA stool test checks stool for any genetic changes that may indicate colorectal cancer.

Screening should be performed every 5-10 years at minimum, depending on individual patient risk factors. Speak to your primary care physician about which screening test may be the best for you. Test preference can vary upon a patient's personal choice, particular medical condition, personal/family history, genetic changes, resources available and several others. These tests may be covered by insurance without any deductible or co-pay. Make it a priority to keep up with your screening tests!

References:

Centers for Disease Control and Prevention. (2022, February 17). Colorectal cancer screening tests. Centers for Disease Control and Prevention. Retrieved June 14, 2022, from https://www.cdc.gov/cancer/colorectal/basic_info/screening/tests.htm

Centers for Disease Control and Prevention. (2022, February 17). What should I know about screening for colorectal cancer? Centers for Disease Control and Prevention. Retrieved June 14, 2022, from https://www.cdc.gov/cancer/colorectal/basic_info/screening/index.htm

Colorectal cancer screening (PDQ®)–patient version. National Cancer Institute. (n.d.). Retrieved June 14, 2022, from https://www.cancer.gov/types/colorectal/patient/colorectal-screening-pdq

Colorectal cancer statistics: How common is colorectal cancer? American Cancer Society. (n.d.). Retrieved June 14, 2022, from https://www.cancer.org/cancer/colon-rectal-cancer/about/key-statistics.html

Screening options. Screening Options - Colon Cancer Screening - UCLA Health. (n.d.). Retrieved June 14, 2022, from https://www.uclahealth.org/colon-cancer-screening/options