You may not know that colorectal cancer (CRC) is the second leading cause of cancer death in the United States, and this year 130,000 new CRC cases will be diagnosed. Now, if someone told you just by doing something pretty painless once every ten years you could lower your risk of being diagnosed with CRC by 90 percent, would you do it?
That something is getting screened. Yet only about 30 percent of all eligible people undergo colorectal screening.
Insurance provisions in The Affordable Healthcare Act make recommended CRC screenings surprising affordable, or free for most adults over age 50. These screenings include colonoscopy, sigmoidoscopy and fecal occult blood tests.
While there are many CRC screening methods, colonoscopy remains the gold standard for prevention. Colonoscopy is a safe and reliable procedure that can diagnose and remove polyps and precancerous lesions during a single procedure in which the patient is sedated. Non-polyploidy lesions occur less often than polyps, but they can also develop into colorectal cancer. Removing polyps or lesions now means they won’t have the opportunity to turn to cancer later.
Colon cancer is preventable in most cases, and while 130,000 people will be diagnosed this year with colon cancer, that is fewer people than 20 years ago thanks to patient awareness and changing attitudes toward screening participation.
Another screening procedure, flexible sigmoidoscopy, involves the physician inserting a long, flexible lighted scope while slowly guiding it through the rectum and into the sigmoid colon. The scope inflates the colon with air to give the doctor a better view. A small camera mounted on the scope transmits a video image from inside the colon to a computer screen allowing the doctor to carefully examine the tissues lining the sigmoid colon and rectum.
While the doctor can look for early signs of cancer and remove polyps during the procedure, this procedure does not allow the entire colon to be seen as with a colonoscopy. Therefore, performing flexible sigmoidoscopy alone can miss a significant number of colonic lesions. For example, two recent studies of over 5,000 colonoscopies have shown that 50% of advanced polyps or cancers were located beyond the reach of sigmoidoscopy.
Fecal occult blood tests look for blood in stools and are used to check for a number of intestinal conditions in addition to colorectal cancer. A small sample of stool is placed on a chemically-treated card, pad or cloth. A special chemical solution is applied to the sample. If it turns blue, blood is present in the stool sample. Blood in the stool may be the only symptom of colorectal cancer, but not all blood in the stool is caused by cancer, therefore it is never used to diagnose colorectal cancer. Further tests will need to be done to diagnose the cause of the bleeding.
Colorectal cancer is more likely to occur as people get older. Although this disease can occur at any age, most people who develop CRC are over age 50. If you have one or more close family members who have been diagnosed with CRC, you could be at a higher risk for being diagnosed yourself. A person’s diet and exercise habits, along with certain types of ulcers can also increase CRC risks.
Your doctor can educate you on your individual risks, and which screening technique is right for you. The most important thing is to take the first step to start the conversation. It’s an uncomfortable subject, but it could save your life.