March is Colorectal Cancer Awareness Month. To raise awareness and knowledge of the disease, the Surgery Group of Los Angeles is putting out a short guide on colorectal cancer screenings and advocating for people over 45 to get their first screening test.
What is Colon Cancer?
Colon cancer, or colorectal cancer, is a common type of cancer that affects the colon or rectum. It develops from abnormal growths in the lining of the colon or rectum, known as polyps, which can become cancerous over time. Symptoms may include changes in bowel habits, blood in the stool, abdominal pain or discomfort, fatigue, and weight loss. Risk factors include age, family history, personal history of polyps or inflammatory bowel disease, and a diet high in red or processed meat and low in fruits and vegetables. Colon cancer is often treatable when caught early through screening tests such as colonoscopies.
When Should I Get Screened?
The age at which you should begin screening for colon cancer depends very much on your symptoms and family history.
If you have a family history of CRC or advanced adenoma in a first-degree relative, it is recommended to undergo a colonoscopy every five years, beginning 10 years before the age at diagnosis of the youngest affected relative, or at age 40, whichever is earlier.
Those with a single first-degree relative diagnosed with CRC or advanced adenoma at age 60 or older may start average-risk screening at age 40.
Colorectal Cancer Screening Tests
Tests for colon cancer are designed to detect cancer before symptoms arise. When done regularly, these tests can find colorectal cancer when it’s smaller and perhaps even easier to treat. While there are many screening options that we would like to go over with you today, the key is that you are tested. The types of tests that the American Cancer Society recommends are split into two major categories: Visual and Stool based screening.
Stool Based tests can be separated into two categories: Blood-based and DNA based. While they are less invasive and simpler to perform, they need to be performed far more often than their Visual counterparts.
- Blood-based tests come in two forms: Fecal Immunochemical (FIT), or Guaiac-based fecal occult (gFOBT). Both can be performed at home and work by finding trace amounts of hidden blood inside of your stool. Both need to be performed once a year and may require you to avoid red meat and some medicines (ibuprofen, aspirin, and large amounts of Vitamin C) several days before testing.
- Stool DNA testing looks instead for certain DNA or gene changes that can form inside of your stool from polyps or cancerous cells. Some tests also check for blood as well. These tests are also can be performed at home, but only need to be done every 3 years
If any of these tests show positive for blood or DNA changes, a colonoscopy must be performed. It does not however mean that cancer has formed in the colon, as it may also be Ulcers or Hemorrhoids.
Visual Tests are recommended for patients that have an average to high risk of having colon cancer. They don’t have to be performed as often as their stool counterparts but often require more lead uptime.
- A Colonoscopy is the most common form of visual test and if nothing is found abnormal on an average risk patient, will not need to be performed for another 5-10 years. A flexible tube is inserted into the anus, where a small camera allows your doctor to observe the totality of your colon and rectum. This test is done under twilight anesthesia. There is of course the “bowel prep” and you will need a ride home, but the test is very safe.
- A CT Colonography is very similar to a colonoscopy but due to it being virtual, does not require sedation. It still requires drinking a bowel prep the day before. If any abnormalities are observed, a follow colonoscopy will need to be performed. While less painful, a CT Colonography must be performed every 5 years.
Regular screening is key in preventing colorectal cancer. If polyps are found during the testing process, they can usually be removed before turning into cancer. If you’re 45 and older talk to your doctor about which test is right for you. Be sure to mention your family medical history, as that will provide key insight into testing your unique situation.