Blog post written by Benjamin Ema, a Family Health Clinic Nurse Practitioner, MSN, APRN, FNP-C
Colorectal cancer is treatable, but each year approximately 1 million people die from this disease. It is the 3rd most common and 2nd deadliest cancer worldwide (WHO, 2023). Today we will discuss how you or your loved ones can change these statistics to find and treat colorectal cancer.
What is colorectal cancer screening?
Colorectal cancer does not produce obvious signs until later stages, so screening is vital to finding colorectal cancer early. There are a few different kinds of tests. The three common methods for screenings are stool samples, CT colonography, and scoping procedures (CDC, 2023). The gold standard is colonoscopy. Nearly everyone you speak to will agree that the preparation, medication to help evacuate bowels, is the worst part of the process. Stool tests range in their ability to find colon cancer.
The three tests include a guaiac-based fecal occult blood test (gFOBT), fecal immunochemical test (FIT), and FIT-DNA test. The gFOBT can be done at home and it evaluates for blood in the stool. FIT tests check for blood and antibodies associated with colorectal cancer. FIT-DNA uses FIT evaluation and also evaluates for DNA changes suspicious for colorectal cancer. The more ways the stool test looks for cancer, the more likely it will find it. If any of these tests are positive, a colonoscopy is highly recommended.
The CT colonography is an image using x-rays to create an image of your colon. This test comes with its risks for radiation exposure, whereas the other tests do not. Before the CT scan, the patient will need to complete the same preparation medication as a colonoscopy and will need to lay still on their back for the whole test.
Finally, the scoping procedures include flexible sigmoidoscopy and colonoscopy. The flexible sigmoidoscopy only evaluates the lower third of the colon. This procedure will not find any colon cancer in the first two-thirds of your large intestine (ascending and transverse colon) whereas the colonoscopy will evaluate the full length of your large intestine. These procedures have the added benefit of potentially removing cancer if small enough along with any non-cancerous or benign polyps.
What is a polyp?
Polyps are growths of tissue that can either be benign (not cancer), precancerous, or cancerous. These growths are typically removed during a colonoscopy or flexible sigmoidoscopy procedure and then sent to the laboratory for analysis.
Do I need to screen for colon cancer?
Current Colorectal cancer screening recommends starting screening at age 45 especially if you have average risk. (USPSTF, 2022)(De Kantar, 2022)(ASCRS, 2020). The American Society of Colon & Rectal Surgeons recommends that if any of the following is true speak to a medical professional about the need for colorectal screening.
- “Are you aged 45* or older?
- Do you or a family member have a history of colon cancer?
- Do you or a family member have a history of colon polyps?
- Do you have a chronic inflammatory bowel disease such as ulcerative colitis or Crohn’s disease?
- Do you or a family member have a history of ovarian, endometrial or stomach cancer?
- Are you of African American or Hispanic descent? (ASCRS, 2020).”
After the test, discuss the results with your gastroenterologist or primary care provider. Always follow up with them to determine when to screen again or what to do with a positive result.
What can you do to prevent colorectal cancer?
There are things you can do to lower your risk for colorectal cancer, such as:
- “Get screened regularly beginning at age 45.*
- Exercise and maintain a normal body weight.
- Eat plenty of vegetables, fruits and high-fiber foods.
- Avoid foods that are high in fat.
- Don’t smoke, and drink alcohol only in moderation (ASCRS, 2020).”
Get the care you need.
If you’re looking for a primary healthcare provider to help you reach your health goals, schedule an appointment with the Family Health Clinic at (800) 321-5043.
References
- American Gastroenterological Association (AGA) (2023). CT Colonography
- American Society of Colon & Rectal Surgeons (ASCRS) (2022). Are you at increased risk for colorectal cancer?
- Centers for Disease Control and Prevention (CDC) (2023). Screening tests
- De Kanter, C. (2022). Colorectal Cancer Screening: Updated Guidelines From the American College of Gastroenterology. American Academy of Family Physicians (AAFP)
- World Health Organization (2022). Colorectal Cancer Awareness Month 2022
