The Importance of Colorectal Screening

The American Cancer Society estimates that in 2019, there will be 101,420 new cases of colon cancer and 44,180 new cases of rectal cancer in the US. Colorectal screening is a critical step to identifying and treating 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 people 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—early detection of any abnormalities. Many of these conditions are more easily treated and managed when found.

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, affecting nearly 1 in 22 men and 1 in 24 women. 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. However, it’s expected to cause 51,020 deaths in 2019.

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 percent. However, only 4 out of 10 cases are detected at this stage.

WHEN SHOULD I GET SCREENED?

The American Cancer Society updated their the colorectal cancer screenings guidelines in 2018. It’s still encouraged that healthy adults ages 50-75 receive routine colorectal screenings, but your doctor may also recommend screenings starting at age 45 if you are at average risk for colorectal cancer, or earlier if your risks are higher. 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. You are considered at average risk of colon cancer if you have a history of Crohn’s disease, familial adenomatous polyposis (FAB), Lynch Syndrome, or if you’ve had radiation to the abdominal or pelvic areas. You are at high risk of colon cancer even if a few of the following risk factors apply to you:

• 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
• You are overweight or obese, which increases your risk of developing colorectal cancer, especially in men.
• You smoke, which increases the risk of developing cancer of any type.
• Your age, as your risk for colorectal cancer increases as you age. You are more at risk if you’re over the age of 50.
• 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.

PREVENTION METHODS

Colorectal cancer is one of the most common forms of cancer, but it’s also one of the most preventable. You can reduce your risk of cancer by making these lifestyle changes:

• Eat a healthy, well-balanced diet – adding more of these foods to your diet is linked to lowering your risks of colon cancer:
  • Eating more vegetables and fruits
  • Drinking three to four eight-ounce glasses of low-fat or fat-free milk daily
  • Adding 25 – 35 daily grams of whole grains and fiber rich foods
  • Lowering your intake of red and/or processed meats
  • Avoid cooking meats at very high temperatures (grilling, boiling, frying)
  • Decrease your sugar intake
• Stay Active – try increasing your activity level as it can reduce your risk of developing colorectal cancer.
• Stay away from smoking – here’s our guide to quitting for those looking to stop.
• Limit alcohol – drinking high amounts of alcohol has been linked with a higher risk of colorectal cancer
• Know your family health history – 1 in 3 people with colorectal cancer have a family member who also had it.
• Try aspirin – studies found that taking low-dose aspirin can help prevent colorectal cancer in some adults.

There are additional risk factors, which you may be able to change or influence. Discuss your health with your physician and they will determine a screening program that best fits your needs and well-being.

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, starting as early as 45 for people with average risk of colon cancer.

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 at age 45 for people at average risk of colon cancer.
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.