Colorectal Cancer Screening and Prevention
Excluding skin cancers, colorectal cancer (a cancer of the colon or rectum) is the third most common cancer diagnosed in men and women in the United States and the second cause of cancer-related deaths in the United States. Louisiana has the country’s fourth-highest death rate of colorectal cancer for a five-year average.
With nearly 28 million Americans not up to date on their screenings, it is important to understand that colorectal cancer is preventable if the correct steps are taken. The key to decreasing new cases is to following routine screening guidelines.
A major development in the field of public health and cancer prevention took place on May 18, 2021 when the U.S. Preventive Services Task Force provided updated recommendations regarding the age to begin screening for colorectal cancer. Adults should initiate screening for colorectal cancer at the age of 45, according to the new guidelines. This is a significant change by the task force, which previously recommended in its 2016 guidelines that screening for this cancer begin at the age of 50.
Those with a higher risk may need to begin colorectal cancer screening before the recommended ages and should discuss increasing screening frequency with their doctor.
Many different screening options are available—including some that you can take in the privacy of your own home. Review the options and speak with your provider to determine that best test for you.
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What Are Your Options for Colorectal Cancer Screenings?
Cancer Prevention Tests: Colonoscopy, Flex Sig
The most familiar preventative method, a colonoscopy, is a procedure which enables a physician to directly image and examine the entire colon. It is effective in the diagnosis and/or evaluation of not only colon cancer, but also various gastrointestinal disorders including colon polyps, inflammatory bowel disease, bleeding or change in bowel habits, abnormal x-rays or CT scans and more.
If a colonoscopy doesn't find a polyp (benign precancerous growth) or cancer and no risk factors are present, doctors recommend scheduling this procedure every 10 years. The number of new cases of colon cancer and deaths from the disease are decreased when a colonoscopy is performed.
Colonoscopy and sigmoidoscopy – or Flex Sig—both use a thin flexible tube with a camera at the end to look at the colon. They differ in the areas of the colon they can see. Colonoscopy examines the entire colon, while sigmoidoscopy is a partial exam that only covers the left side of the colon.
Cancer Detection Tests: Stool Occult blood testing with FIT Test, Cologuard
A simple cancer detection test known as a fecal immunochemical test (or FIT Test) is distributed via your primary care provider and completed at home by mailing in a stool sample. FIT is available for average risk patients 50 years of age and older and should be performed annually. These at-home tests can help find colon cancer at an early stage when it can be treated, even before any signs or symptoms develop.
No dietary restrictions are required leading up to the testing period— FIT has highly accurate results since it detects only blood from the lower-GI tract where polyps and colorectal cancer develop. If a patient receives a positive test result, further evaluation is necessary, and the American Cancer Society recommends follow-up with a colonoscopy.
Another at-home cancer detection test for colorectal cancers, Cologuard identifies altered DNA and/or blood in stool, which are associated with the possibility of colon cancer or precancer. Cologuard is covered by Medicare every three years for average risk patients between the ages of 50-85 and is recommended every three years by the American Cancer Society.
Cologuard uses a molecular biology process to capture specific pieces of DNA for further analysis. A positive result may indicate the presence of colorectal cancer or advanced adenoma and should be followed by diagnostic colonoscopy.
Because it is possible to receive a false positive diagnosis when at-home testing, it is important to discuss all screening options with your doctor before moving forward with the screening process.
It has been proven that a program that offers patients a fecal screening option like FIT or Cologuard is likely to have higher participation than a program that offers only colonoscopy. Although not intended to replace a colonoscopy, preliminary screening tests like FIT and Cologuard are extremely helpful in finding colon cancer at an early stage when treatment options are still available.
Regular colorectal cancer screening is one of the most powerful weapons for preventing colon cancer today. Take the first step and discuss your options with your healthcare provider to ensure you are on the road to good gut health.