By Dr. Paul Williams, Baptist Health Gastroenterology Clinic
March is Colorectal Cancer Awareness Month.
This annual reminder is important because more than 100,000 cases of colorectal cancer occur yearly. Colorectal cancer is the 3rd most common cancer behind lung cancer and breast cancer.
1 in 4 men and 1 in 6 women will have polyps in the colon. Polyps are grape-like growths that occur in the colon, and this is where cancer usually starts. This cancer is preventable with screening and early polyp removal—remove the polyp and remove the chance of cancer forming in the polyp. Unfortunately, it is estimated that only 50% of those eligible for colon cancer screenings follow through and get the procedure performed.
What is a colon cancer screening?
It is a process involving looking inside the colon to search for colon polyps or small tumors.
Who should be screened for colorectal cancer?
Everyone starting at the age of 45 should be screened for colorectal cancer. Be sure to check with your insurance provider between the ages of 45-50.
What if I have a family history of colon cancer or colon polyps?
If you have a first-degree relative (father, mother, brother, sister, son or daughter) with colon cancer diagnosed prior to 60 years of age, you should have your first colon exam at either age 40 or 10 years younger than the age of your relative’s diagnosis. For example, if the relative has colon cancer at age 46, you should have your first colon exam at age 36.
How is colorectal cancer screening performed?
Colonoscopy
This is the gold standard for colorectal cancer screening. In a colonoscopy, a flexible, lighted tube is inserted in the colon and the entire colon is visually examined. It is both a diagnostic and therapeutic test, meaning if a polyp is found it can be removed at that time. This test does require a bowel prep, and is safe and comfortable with the use of sedation.
Air Contrast Barium Enema Radiography
In the air contrast barium enema radiographic procedure, contrast is instilled in the colon and X-rays are taken looking for polyps. This test does require a bowel prep, and no sedation is used. If a polyp is found, the patient will need to be referred for a colonoscopy to remove the polyp.
CT Colonography
CT colonography is a special CT scan where contrast is injected into the colon and images are taken looking for a polyp. This test does require a bowel prep, and no sedation is used. If a polyp is seen, the patient will need to be referred for a colonoscopy.
Cologuard
With the Cologuard test, a stool sample is collected at home and sent off to a special lab for testing. This uses special DNA technology to test for cells shed in the colon by colon cancers or polyps. If the test is positive, the patient will need to be referred for a colonoscopy. This test requires a prescription from a physician, and is covered by Medicare and most insurance companies for average risk individuals starting at the age of 50 and every 3 years thereafter. Average risk is defined as any person who does not have a prior history or colon polyps or colon cancer, and does not have a first-degree relative with colon polyps or colon cancer.
How often should I receive colon cancer screening?
Average risk individuals with no polyps found and no family history of polyps or cancer should be tested every 10 years after the first exam. If polyps are found, colon exams should be repeated in 3 years. If you have a first-degree relative with colon cancer, exams should be repeated every 5 years after the first exam.
Remember, colorectal cancer is common, but it is preventable and potentially curable with screening and early intervention. Everyone should be screened starting at the age of 45, or younger if there is a family history of colorectal cancer. Learn more about colorectal cancer or request an appointment with a primary care provider to discuss colorectal cancer screenings.
