In the United States, colorectal cancer is the third leading cause of cancer-related deaths for both men and women.
According to the American Cancer Society, colorectal cancer is expected to cause around 52,580 deaths in 2022 alone. Despite that, colorectal cancer is very easily preventable and treatable if caught early with screening.
A colonoscopy is a procedure that allows a surgical team to view inside the entire colon and rectum while the patient is sedated. The great news is that the screening procedure is painless, and the patient often does not remember the procedure after waking when the colonoscopy is completed.
While the colonoscopy is being performed, the physician looks for signs of cancer or polyps. Polyps are best described as small lumps or moles that grow inside the large intestine or rectum. When a polyp is found during a colonoscopy, the physician can remove it and have it tested for cancer. Polyps are generally considered precancerous if found and removed early.
Signs and Symptoms of Colorectal Cancer
Colorectal cancer usually does not show symptoms for many years. On average, it takes a polyp between five to 10 years to develop into cancer. Usually, when a patient develops symptoms, the cancer is already in a late stage.
Some common symptoms of colorectal cancer include blood in the stool, changes in bowel habits, abdominal pain or cramps that don’t go away, anemia and weight loss.
Risk Factors and When to Screen
Like every form of cancer, colorectal cancer has specific risk factors that contribute to the likelihood of someone developing it.
Some risk factors of colorectal cancer can be controlled, including being overweight, an inactive lifestyle, a diet high in red meats and processed foods, alcohol use and smoking.
Other risk factors cannot be controlled, such as aging, a personal history of inflammatory bowel disease, an inherited syndrome or family history.
So when should someone get screened for colorectal cancer? The American Cancer Society recommends that people with an average risk begin regular screenings at age 45.
However, if a family member has had colorectal cancer or precancerous polyps removed during a colonoscopy, the risk increases. Those with a family history of polyps or colorectal cancer should be screened 10 years prior to when the polyp or cancer was found in the family member if they are below the recommended age of 45.
It is important to note that African Americans have the highest colorectal cancer rate and associated mortality rate of all ethnic groups in the United States. Because of this, early screening is imperative to reduce the rate of colon cancer and related deaths in African Americans.
Types of Tests
Colonoscopy is the only proven method to prevent colon cancer. There are stool-based tests that can help detect colorectal cancer, but they fail to detect precancerous lesion in many patients. If you think undergoing a stool test is best for you, keep in mind that an abnormal result will require you to undergo a colonoscopy to determine what the problem actually is. So, why not start with the screening that provides the most reliable results?
Patients may get a false sense of security with a stool test, thinking they have undergone proper prevention, when in reality, they have not. Even newer stool-based tests failed to detect precancerous lesion up to 40-60% of the time. Therefore, even though they are approved tests, do not miss the opportunity to prevent colon cancer because of a lack of information.
Having yourself or a loved one undergo a major surgery or chemotherapy; and waking up every morning for years wondering if colorectal cancer will return, adds a significant amount of stress to your life and your family. Colonoscopies are the only tests that can detect and remove precancerous polyps before they turn into colorectal cancer. In most cases, lesions can even be removed during the colonoscopy, allowing you to avoid a major surgery.
Prevention is Key
Be your own health care advocate! If you are 45 or older, ask your doctor to help you book a colonoscopy. If you have a family history of colon cancer or colon polyps, ask your doctor to help you schedule a colonoscopy, starting 10 years before the age your family member was diagnosed with colon cancer or colon polyps. If you have symptoms of colorectal cancer, talk to your doctor about a colonoscopy right away. If you have a significant family history of colon cancer or colon polyps, a genetic evaluation may be best for you, and screening should be tailored to your own personal situation.
Understanding that colon polyps and colon cancer run in families, please let your siblings, brothers or sisters and parents know if you have polyps or were diagnosed with colorectal cancer. Be the first to help to keep your loved ones safe, as they may need to undergo screening as well. Overall, the most important point is to get screened. No matter what test you choose. However, keep in mind that not all tests are the same when it comes to prevention.
Raul Bosio, MD, is a board-certified colon and rectal surgeon with ProMedica Physicians General Surgery. View his profile.