Have a Conversation with Your Doctor about Colorectal Cancer Screening
Find out what colorectal cancer is, what your risk factors are and the screening methods available to detect colorectal cancer.
Colorectal cancer is a topic that people often feel uncomfortable discussing. But, because it goes undiscussed, it can also go undetected making it a far more deadly cancer than it should be. While death rates for colorectal cancer are dropping, it remains the third most common cancer diagnosed in the United States, according the American Cancer Society. It is estimated that over 100,000 new cases of colon cancer and over 45,000 new cases of rectal cancer will be diagnosed in 2021 and rates are rising among those under the age of 65.
The key to reducing deaths from colorectal cancer is a renewed focus on education and screening. Understanding what to look for and when to be screened helps people know when to go to the doctor to be assessed for colorectal cancer before it becomes deadly.
What is colorectal cancer?
The colon and rectum are the final stages of the digestive system. Colorectal cancer can occur in any portion of the colon or rectum. The cancer begins as a growth on the inside of the colon or rectum called a polyp. The polyps are not cancerous at first but they may become cancerous over time depending on what type they are. Other factors, such as the size of the polyp or the number of polyps, can make it more likely that they will become cancerous.
Left undetected, a cancerous polyp can spread cancer into the walls of the colon or rectum. This, in turn, can lead to the cancer spreading to nearby blood vessels and lymph nodes. The cancer can then be transported throughout the body via the blood and lymph system.
What are the risk factors?
A number of risk factors may cause individuals to be more likely to develop colorectal cancer. These include:
- Being overweight or obese
- Lack of physical activity
- Poor diet or diets high in red or processed meats
- Alcohol use
Other uncontrollable factors that may lead to a higher likelihood of colon cancer are:
- A family history of colorectal cancer
- A personal history of colorectal polyps or colorectal cancer
- A history of inflammatory bowel disease
- Type 2 diabetes
- Racial or ethnic background (African Americans and Ashkenazi Jews have a higher incidence of colorectal cancer)
- Other inherited genetic factors
What are the screening methods for colorectal cancer?
Fortunately, screening for colorectal cancer can discover polyps while they are small and before they spread. Screening methods include either fecal sample tests or colonoscopy. Fecal sample tests or fecal immunochemical tests, referred to as FIT tests, are an effective screening tool used to detect blood in the stool. Blood in the stool can be a sign of cancer. FIT tests fall into two categories:
- FIT. A once-a-year test.
- FIT-DNA. A once every three years test.
Both FIT screenings can be completed in the privacy of a patient’s home using a kit provided by a doctor. Both tests involve a single sample that a patient returns to a lab location for testing. Most people prefer these easy, at-home screenings as they do not require any advance preparation, sedation or a scheduled appointment. A positive result from a FIT screening must be followed by a colonoscopy.
A colonoscopy is a physical exam of the colon that is performed by a doctor using a colonscope inserted into the rectum. A tiny camera on the colonscope allows the doctor to view inside the colon. If any polyps are found during the colonoscopy, the doctor is able to remove and subsequently test them for cancer.
All individuals over age 50, or those younger with a risk factor for colorectal cancer, should speak with their primary care provider about which screening option would be most appropriate for them. Whether an at-home, non-invasive FIT test or a colonoscopy, screening is a crucial step in finding polyps early and stopping colorectal cancer in its tracks. Take charge of your health by having the conversation.