The NEW Age to Be Screened for Colon Cancer
45 Is the New Age to Be Screened for Colon Cancer
The USPSTF and the American Cancer Society released new information on what age you should be screened for proper cancer detection. The age that they advise you should be screened is 45 years of age.
People at an average risk of colorectal cancer - with no personal or family history of colorectal cancer or inflammatory bowel’s disease or personal history of abdomen or pelvic radiation treatment - are recommended to start regular screening at age 45. Guidelines are complex for people at increased or high risk, so it’s recommended to speak with your healthcare provider if you fall into this category.
Before you decide how you want to get tested, educate yourself on options below.
Testing options for colorectal cancer
Colonoscopy
A colonoscopy is the most common and effective way to screen for colon cancer. The procedure for the colonoscopy is where a doctor inserts a colonoscope (a flexible tube about the width of a finger with a light and small video camera on the end) into the anus to pass through the rectum and colon. The doctor looks at the entire length of the colon and rectum with the colonoscope. If necessary, special instruments can be passed through the colonoscope to biopsy (take a sample) or remove any suspicious-looking areas such as polyps.
A colonoscopy can be used to detect many different types of conditions. Some people may avoid the procedure due to embarrassment or a reluctance to do the preparation. There are many bowel preparations available, and they come in different sizes and tastes. Also, the colonoscopy team respects your privacy during the entire procedure. Colonoscopies are only needed every 10 years if you have no signs of cancer or polyps.
Most importantly, a colonoscopy is the only test that can actually prevent colon cancer by removing polyps before they become cancerous!
Stool-based tests
Stool-based tests need to be done more often than other tests, but can be done from the privacy of one’s home, so many people find them easier than tests like a colonoscopy. They look at the stool (feces) for possible signs of colorectal cancer or polyps (small growths that can become cancer over time). If the result from one of these stool tests is positive (abnormal), you will still need a colonoscopy to see if you have cancer.
Fecal immunochemical test (FIT)
The fecal immunochemical test must be done every year. One way to test for colorectal cancer is to look for occult (hidden) blood in the stool from the lower intestines. Damaged blood vessels in larger colorectal polyps or cancers usually bleed into the colon or rectum. Keep in mind that the amount of blood that is passed is typically invisible to the naked eye.
The FIT test is considered one of the easier tests to take because there are no drug or dietary restrictions and can be done in the privacy of your own home. If hidden blood is found in the stool, a colonoscopy will need to be done to investigate further. Although blood in the stool can be a result of cancer or polyps, it can also be from ulcers, hemorrhoids, and other conditions. If the test result is positive, a colonoscopy will be needed to find the reason for the bleeding.
Guaiac-based fecal occult blood test (FOBT)
The guaiac-based fecal occult blood test (FOBT) must be done every year and can be done in the privacy of your own home. It checks more than one stool sample to find occult (hidden) blood in the stool through a chemical reaction. The gFOBT test checks more than one stool sample. Some foods or drugs can affect the results of this test, so you may be instructed to avoid certain food and drugs before this test.
If the test result is positive (if hidden blood is found), a colonoscopy will be needed.
Stool DNA test
A stool DNA test should be done every 3 years. It can be done in the privacy of your home and there are no food or dietary restrictions before taking the test. A stool DNA test looks for certain abnormal sections of DNA from cancer or polyp cells and also for occult (hidden) blood. Colorectal cancer or polyp cells often have DNA changes. Cells with these mutations often get into the stool, where tests may be able to find them. Cologuard is the only test currently available in the US that tests for both DNA changes and blood in the stool (FIT).
If the test is positive (if it finds DNA changes or blood), a colonoscopy will be need to be done.
CT colonography (virtual colonoscopy)
This test is an advanced type of computed tomography (CT) scan of the colon and rectum. It does not require sedation or any type of instrument or scope being put into the rectum or colon. This test may be useful for some people who can’t have or don’t want to have a more invasive test such as a colonoscopy. It can be done fairly quickly, but it requires the same type of bowel prep as for a colonoscopy. It shows abnormal areas, like polyps or cancer. Special computer programs use both x-rays and a CT scan to make 3-dimensional pictures of the inside of the colon and rectum.
If polyps or other suspicious areas are seen on this test, a colonoscopy will still be needed to remove them or to explore the area fully.
There are possible side effects and complications, including bloating or cramps because of the air in the colon and rectum, but this should go away once the air passes from the body. There’s a very small risk that inflating the colon with air could injure or puncture it, but this risk is thought to be much less than with colonoscopy. Like other types of CT scans, this test also exposes you to a small amount of radiation.
Flexible sigmoidoscopy
A flexible sigmoidoscopy is very similar to a colonoscopy, but it doesn’t examine the entire colon. This test is not very common in the United States. A sigmoidoscope (a flexible, lighted tube with a small video camera on the end) is put into the anus, and passed through the rectum to the lower part of the colon. Because the sigmoidoscope is only about 2 feet (60cm) long, the doctor only sees less than half of the colon and the entire rectum. Images from the scope are seen on a video screen so the doctor can find and possibly remove any abnormal areas.
You would likely be asked to lie on a table on your left side with your knees pulled up near your chest. Your doctor may insert a gloved, lubricated finger into your rectum to examine it. The sigmoidoscope is also lubricated to make it easier to put into the rectum. Air is then pumped into the colon and rectum through the sigmoidoscope so the doctor can see the inner lining better, which can naturally lead to discomfort. Be sure to let your doctor know if you feel pain during the procedure.
If you are not sedated during the procedure, you might feel pressure and slight cramping in your lower belly. To ease discomfort and the urge to have a bowel movement, it may help to breathe deeply and slowly through your mouth. After the test, you’ll feel relief once the air leaves your bowels.
Why Detecting Polyps Matters
Colon polyps are growths in the colon which could potentially become colon cancer. There are three types of screenings for colon polyps:
Colonoscopy – 95% of large polyps detected
Stool DNA (Cologuard®) – 42% of large polyps detected
FIT/FOBT – 30% of large polyps detected
Unfortunately, the majority of large polyps go undetected with stool tests. When polyps aren’t found and removed, you are at risk for developing colon cancer. A colonoscopy is the gold standard for finding polyps. If polyps are found during a colonoscopy, they are removed during the same single procedure. This eliminates the need for additional procedures or tests.
If polyps are suspected through FOBT, FIT or Stool DNA, a colonoscopy must be performed to remove the polyps.
Take the next step
Now that you are educated on colorectal screening options, please take the next step to set up your appointment to speak with your healthcare provider.
Source: American Cancer Society