The Importance of Colorectal Screening

The American Cancer Society estimates that in 2018, there will be 97,220 new cases of colon cancer and 43,030 new cases of rectal cancer in the US. Colorectal screening is a critical step in early identification and treatment of polyps that may lead to developing colorectal cancer.

What is a colorectal screening?

Screening tests are used to check for abnormalities and precursors in otherwise healthy persons exhibiting no symptoms. As we age, routine screenings become more common for conditions such as colorectal cancer, diabetes, heart disease, and more. Screenings may vary based on age, gender, and genetic history, but they all have one thing in common—with early detection of any abnormalities, many of these conditions are more easily treated and managed.

If you have a family history of colorectal cancer, a colonoscopy or sigmoidoscopy (described below) may be recommended. Based on your individual circumstances, your doctor will work with you to determine which tests are best for you.

Routine Screenings & Early Detection

Colorectal cancer is the second leading cause of cancer mortality in men and women combined. In the last few decades, the mortality rate for colorectal cancer has continued to drop due to the increase in routine screenings, early detection, and early removal of polyps.

Polyps can take as long as 10-15 years to develop into colorectal cancer. Regular screenings can prevent colorectal cancer, as medical specialists can remove polyps before they turn into cancer. Additionally, routine screenings lead to early detection and diagnosis of colorectal cancer, easing the treatment process and increasing the chances of remission or cure. When colorectal cancer is discovered in its early stages, the 5-year relative survival rate is approximately 90%!

Frequency of Screenings

It is recommended that adults ages 50-75 receive routine colorectal screenings. If you have increased risk factors for colorectal cancer (see below), your doctor may recommend a screening prior to age 50. Adults over the age of 76 should ask their doctor if screenings are recommended.

Risk Factors

Certain uncontrollable risk factors may indicate the need to begin colorectal screenings at an earlier age. These factors include:

  • You or a relative have a history of colorectal polyps or colorectal cancer.
  • You suffer from an inflammatory bowel disease such as Crohn’s disease or ulcerative colitis.
  • You have a genetic syndrome such as familial adenomatous polyposis (FAP)or hereditary non-polyposis colorectal cancer (Lynch syndrome).
  • You have Type 2 Diabetes
  • Your age, as your risk for colorectal cancer increases as you age.
  • Your race/ethnicity
    • African Americans have the highest colorectal cancer incidence in the US
    • Jewish people of Eastern European descent (Ashkenazi Jews) have one of the highest colorectal cancer risks of any ethnic group in the world.

There are additional risk factors, which you may be able to change or influence. These include:

  • Being overweight or obese increases your risk of developing colorectal cancer, especially in men.
  • Physical inactivity. Try increasing your activity level as it may reduce your risk of developing colorectal cancer.
  • Certain types of diets
    • Diets high in vegetables and fruits, and whole grain fibers have been linked with a lower risk of colorectal cancer
    • High in red and/or processed meats
    • Cooking meats at very high temperatures (grilling, boiling, frying) may raise your overall cancer risk
  • Smoking increases your risk of developing cancer of any type.
  • Heavy alcohol use has been linked to colorectal cancer.

Discuss all of your risk factors with your physician and they will determine a screening program that is best fits your needs and health background.

Colonoscopy vs. Sigmoidoscopy

A colonoscopy allows your doctor to view the entire colon and rectum. During the procedure, the doctor will look for polyps, which may turn into colorectal cancer if left intact, and during the procedure, polyps may be removed. A small scope, called a colonoscope, is inserted into the colon and images are projected on a monitor screen in the exam room. The procedure takes about 30 minutes and medications are used for relaxation and sedation during it. Your doctor will take images throughout the test and discuss any areas of concern during your post-procedure consultation. Pending normal results, colonoscopies are usually performed every 10 years, beginning at the age of 50.

During a sigmoidoscopy, your doctor views your rectum and a smaller portion of your colon, checking for polyps. A thin, flexible, lighted tube equipped with a small video camera, called a sigmoidoscope, is inserted into your rectum. The scope is approximately 2 feet long and your doctor is able to see the entire rectum but less than half of the colon with this exam. The procedure takes between 10-20 minutes and most patients do not need sedation or relaxation medications. Pending normal results, sigmoidoscopies are usually performed every 5 years, starting after the age of 50.

NWPC is here to help! Our primary care physicians will work with you to determine a colorectal screening plan that best meets your needs. Have questions? Our staff is here to provide you with resources and excellent comprehensive care.