Colorectal cancer (cancer of the large intestine) is the second leading cause of cancer deaths in the United States. To put it into perspective, colorectal cancer is expected to cause more than 50,000 deaths in 2023.
These cancers typically start out as small growths in the colon. If the polyps are identified and removed at this stage, they are harmless. However, if they are not removed, they can progress to cancer, spread to other parts of the body, be much more difficult to treat, and lead to serious illness and/or death.
In this blog, I will break down why screening for colon cancer is so important, who should be screened, and what that process may look like.
Why is colon cancer screening important?
Colon cancer can cause symptoms like:
However, these symptoms often do not appear until the polyps or cancer have progressed and become more difficult to treat or even life-threatening.
- Blood in the stool
- Weight loss
- Stomach or abdominal pain
- Changes in stool shape or consistency
To prevent this from happening, it is important to find these polyps and remove them before they have the chance to turn into cancer and to identify any cancers as early as possible. Therefore regular colon cancer screening is important.
When should I start to get screened for colon cancer?
In the past, we suggested patients start screening for colon cancer at age 50 (or earlier if there are concerning symptoms or other risks - like family history). However, over the past several decades, there has been a significant increase in colon cancer in patients under the age of 50.
This has several organizations - including the American Cancer Society (ACS) and the United States Preventative Task Force (USPSTF) - suggesting patients start screening at age 45. However, if you have a family history, or other symptoms be sure to discuss them with your primary care doctor because you may need testing sooner than age 45.
How can I check for colon cancer?
There are several ways to test for colon cancer. The most common way to be screened is with a colonoscopy. However, there are also non-invasive tests that look for colon cancer – like Cologuard.
During a colonoscopy, you are given sedation to make you sleepy and relaxed. Then a long, thin camera called a “colonoscope” is inserted to the colon and used to look for any polyps or cancers. The camera can also be used to remove polyps.
Prior to the colonoscopy, you will be asked to “prep” using laxatives. This will clean out the colon prior to the procedure. Many patients find that this is the most difficult part of the entire procedure.
It’s important to remember a colonoscopy is a procedure, so there is a small risk of problems. Patients could have an issue with the medications used for prep or during the procedure. There is also the possibility the colon will be damaged during the procedure.
This test has become more common lately. The Cologuard test looks for signs of polyps or cancer in the stool. This test is less invasive than a colonoscopy but does have some drawbacks, including:
- It should not be used for patients who have risk factors for colon cancer such as a personal or family history or certain types of polyps.
- It can miss a small number of polyps or cancers.
- If the test is abnormal, you will still need a colonoscopy to identify the problem.
How often should I be screened and when should I stop screening?
If your colonoscopy is normal, and you do not have any other risk factors for colon cancer, you should have a repeat screening in 10 years.
If you have a normal Cologuard test you should be tested again in 3 years.
Currently, most experts suggest stopping colon cancer screening at age 75. However, additional tests may be suggested if a patient has a family history of colon cancer, or if previous tests were abnormal.
A colon screening can detect colorectal cancer in its earliest stages. This means it probably has not metastasized and will be easier to treat. So, if you are at least 45 years of age, we strongly recommend you get screened.
To schedule a screening visit: https://www.carenewengland.org/schedule-a-colonoscopy
Disclaimer: While I am a doctor, I am not your doctor. The content in this blog is for informational and educational purposes only and should not serve as medical advice, consultation, or diagnosis. If you have a medical concern, please consult your healthcare provider, or seek immediate medical treatment.