Should I be getting screened for colorectal cancer?

The short answer is likely yes! All men and women should be screened for colorectal cancer.  The American Cancer Society recommends that all adults including those without a family history of colorectal cancer should begin colorectal cancer screening at age 45 and continuing being screened through the age of 75 or as directed by their physician. Colon cancer is one of the most common cancers diagnosed in men and women in the United States and most often occurs among people 50 and older. It is the number two cause of cancer death in both men and women. Careful attention and colorectal screening can be the difference between life and death.

 

What is colorectal cancer screening?

Colorectal cancer screening is a test that is used to look for the presence of a disease when a person does not have symptoms. When a person has symptoms, diagnostic tests are used to find out the cause of the symptoms.

Colorectal cancer typically develops from precancerous polyps (abnormal growths) in the colon or rectum. Colorectal screening tests are designed to find precancerous polyps so that they can be removed before they turn into cancer. Screening tests can also find colorectal cancer early when treatment is most effective.

 

What are the key risk factors of colorectal cancer?

Key individual risk factors such as ethnicity, lifestyle, and family history can also influence when you should start getting checked. If you fit into one or more of the groups below you may need to be screened sooner:

●      If you are currently experiencing symptoms you should talk to a doctor immediately.

●      If you have a family history of colorectal cancer or polyps it is a good idea to begin screening at 40, or 10 years before the youngest case in your family.

●      If you are African American you should get screened by age 45.

●      If you have a genetic link to colorectal cancer such as Lynch Syndrome or FAP it is a good idea to get tested in your early 20s, or 2 to 5 years younger than the youngest case in your family.

●      If you have a personal history of cancer it is good to consult with your doctor about when to be screened, but you likely will want to begin before the age of 45.

●      If you have ulcerative colitis, inflammatory bowel disease, or Crohn’s disease it is good to consult with your doctor about when to be screened, but you likely will want to begin before the age of 45.

 

Is colorectal cancer screening the same as a colonoscopy?

A colonoscopy is a type of colorectal screening but it is not the only option. Today there are two primary types of screening examinations that are offered in a variety of forms:

 

Stool-based tests

●      Fecal immunochemical test (FIT) - This is a yearly test that has no direct risk to the colon nor does it require bowel prep. A sample for the fecal immunochemical test can be collected at home making it more comfortable than some alternatives, but it also has the potential to miss some polyps and cancers and may on occasion return false positive results. If the test returns a positive result a colonoscopy will also be required.
 

●      Guaiac-based fecal occult blood test (gFOBT) - This is an inexpensive yearly test that has no direct risk to the colon nor does it require bowel prep. The sampling can be done at home but often requires some modifications to the patient’s diet and medication usage prior to the test. Similar to other stool-based tests, the guaiac-based fecal occult blood test has the potential to miss some polyps and cancers and can also return false positive results. In the event a positive result is returned, a colonoscopy will be required.
 

●      Stool DNA test - This is a newer form of colorectal screening that has grown in popularity due to the ease of sampling and testing. A sample can be collected at home and sent in for testing. With stool DNA testing, there is no direct risk to the colon nor is there any bowel prep required but much like other stool-based tests there is a risk of missing some polyps and cancers as well as a risk of false-positive tests. In the event a positive result is found a colonoscopy will be required for further examination. If you are considering a stool DNA test make sure to check with your insurance provider to confirm coverage. As a newer test insurance coverage is not always available to cover these tests or there may be restrictions.

 

Visual exams

●      Colonoscopy - This is the most accurate and complete form of testing. During a colonoscopy a doctor will examine the entire colon looking for polyps and they will even biopsy and remove polyps as needed. A colonoscopy will typically spot all except the smallest of polyps and can even help identify other diseases the patient may have. A colonoscopy does require sedation and may have a day of recovery time required.
 

●      CT colonography (virtual colonoscopy) - This is a procedure similar to a colonoscopy but less invasive. A CT colonography is a quick and safe procedure where your doctor performs a CT scan of your abdomen and pelvis to create 3D images that allow your physician to identify polyps and other abnormalities inside your colon and rectum. This is a non-invasive test that should be done every 5 years. A CT colonography does not require sedation but it does require full bowel prep. While very effective, the CT colonography can miss small polyps and can also result in false positives. If a positive result is found a full colonoscopy will be required. It is also important to note this is a newer procedure and there is the potential for some insurance coverage issues, so check with your provider for more information.
 

●      Flexible sigmoidoscopy - This is a camera-based test where a small flexible camera called a sigmoidoscope is inserted into the anus and moved to the lower part of the colon to inspect the colon and rectum. This is a quick and safe procedure that can be performed without sedation but can result in some minor discomfort. Typically done every 5 years in combination with a yearly fecal occult blood test this procedure can help identify all but the smallest polyps but is less commonly used because it only examines about a third of the colon. In the event a positive result or abnormality is identified a colonoscopy will still be required.

 

What is the best screening option?

The most accurate and effective method to screen for colorectal cancer is the colonoscopy but it is also the most involved procedure. We recommend consulting with your physician regarding the right procedure for your risk-level and health.
 

Does insurance cover colorectal screening?

Typically, but you should check with your insurance provider to determine your colorectal cancer screening benefits. Most insurance providers cover colonoscopy for colon cancer screening, however, insurance coverage varies from providers as do the specifics of what is covered.

 

Where do I get a colorectal cancer screening?

If you are located in the greater Puyallup, Washington area our team can certainly provide screening for you. If you are outside of the area we recommend you contact your healthcare professional to get a referral to a service provider in your area.

 

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