8 Things to Know About Colorectal Cancer Screenings
Rates decreasing in older adults, increasing in younger
Rates decreasing in older adults, increasing in younger
It’s not something most people want to talk about, but by age 45 – or maybe younger if you have risk factors – you should have a conversation with your doctor about colorectal cancer.
Regular screening exams for colorectal cancer – also known as colon cancer and rectal cancer depending on where it starts – can find cancer at an early stage before it has spread.
“When colorectal cancer is diagnosed at earlier stages, treatment options are more successful,” says Walter Coyle, MD, a gastroenterologist with Scripps Cancer Center and Scripps Clinic. “That is why it’s important when the time comes to talk to your doctor about when and how you should be screened for colon cancer.”
The risk of getting colorectal cancer increases as you get older. Other risk factors include having inflammatory bowel disease, family history of colorectal cancer or a genetic syndrome.
There are now three main types of screening for colorectal cancer: stool-based tests, a new FDA approved blood test and direct visual exams.
Colon cancer basics
Colorectal cancer is preventable through screening early detection. Here are eight critical facts about colon and rectal cancer.
1. Colorectal cancer is third most common cancer in U.S.
The American Cancer Society estimates that 107,320 new cases of colon cancer and 46,950 new cases of rectal cancer will be diagnosed in the U.S. this year. Women have a slightly lower risk than men of developing the disease.
Colorectal cancer is also the third leading cause of cancer-related deaths in men and the fourth leading cause in women. It is expected to cause about 52,900 deaths this year.
Colon cancer is now the leading cause of cancer death in men younger than 50 years old, according to the American Cancer Society.
2. Colorectal cancer develops slowly, with few early signs or symptoms
Colorectal cancer almost always starts with an abnormal growth known as a polyp in the colon or rectum. Not all polyps are malignant. A polyp, however, can take as many as 10 years to develop into cancer. This is why there are generally few symptoms during the early stages of the disease.
As it progresses, symptoms may include blood in the stool, rectal bleeding, abdominal pain, or a change in bowel habits that lasts for a few weeks or more, such as diarrhea, constipation or narrowing of the stool. If you notice any of these symptoms, call your doctor.
“Other conditions may also cause these symptoms, so it is important to identify the cause and get treatment,” Dr. Coyle says.
3. Screening can prevent colorectal cancer
Because polyps in the colon or rectum grow so slowly, the goal is to find and remove them before they become cancerous.
When colorectal cancer is found early, the five-year survival rate is about 90%. Only 4 in 10 colorectal cancers are found at the early stage.
There are several types of colorectal screening tests. Some only detect potentially cancerous growths, while others detect and remove them.
4. Follow doctor’s recommendation for screening
Regular screening for people at average risk is recommended at age 45. The recommended age was lowered a few years ago from 50 to 45 by the U.S. Preventive Services Task Force and the American Cancer Society. The change was in response to studies that show a rise in the rates of colorectal cancer among younger adults.
“If you have a family history of colorectal cancer or risk factors such as inflammatory bowel disease, your doctor may recommend having your first screening at a younger age,” Dr. Coyle says.
Younger adults concerned about colorectal cancer should watch out for symptoms that are consistent with the disease, including pain, bleeding, altered bowel habits or changes in stool patterns.
Black Americans are at higher risk for colorectal cancer than other racial and ethnic groups. Lower screening rates among Black Americans is a major factor.
5. Colorectal cancer is declining in older adults, increasing in younger adults
The rate of colorectal cancer cases has been declining since the mid-1980s, due largely to more people getting screened. Colorectal polyps can be found by screening and removed before they can develop into cancers.
The decline has been mostly among adults 50 and older. About 7 in 10 adults aged 50 to 75 are up to date with colorectal cancer screenings, according to the Centers for Disease Control and Prevention.
Colorectal cancer cases among people younger than 50 have been increasing since the mid-1990s, according to the American Cancer Society.
6. Colonoscopy is considered gold standard
A colonoscopy is a visual exam that is considered the “gold standard” for colorectal cancer screening. It is performed while you are sedated, so you do not feel or see anything.
A doctor inserts a flexible tube with a small camera into the rectum to examine the entire length of the colon. If precancerous polyps are found, they often can be removed during the procedure. For most people, colonoscopy screenings should be repeated every 10 years.
7. Other screening tests are used to detect abnormal growths indirectly
A FIT, or fecal immunochemical test, analyzes a stool sample for signs of blood from cancer. No prep is necessary. However, this test is not as accurate as a colonoscopy. If cancer is suspected or the FIT test is positive, a colonoscopy is needed. Usually, the FIT test is performed every year.
Another stool test, called Cologuard, detects abnormal DNA and blood in the stool. It is more sensitive than the FIT test but has more false positive results. It is performed every three years. If the test is positive, a colonoscopy is recommended.
The FDA recently approved a new blood test, called Shield by Guardant, for colon cancer screening. It detects abnormal DNA in your blood. It is less sensitive and specific than stool tests but has been shown to detect most colon cancer and some polyps. It is performed every three years. If the test is positive, a colonoscopy is recommended.
8. You can change certain risk factors to decrease your risk of colon cancer.
Many lifestyle-related factors that have been linked to colorectal cancer can be changed, including diet and weight.
Your risk of developing and dying from colorectal cancer is higher if you are overweight or obese. Avoiding red meat, eating healthily and exercising can help you attain and maintain a healthy weight and lower your risk of developing colorectal cancer. Avoiding smoking and decreasing alcohol use also decreases your risk.
There is new data that taking Vitamin D (especially for women) and drinking coffee regularly decreases the risk of colon cancer. It does not matter if the coffee is caffeinated or not.
Cancer care at Scripps
Cancer specialists at Scripps treat almost all types of adult cancer, including colorectal cancer. Our patient-centered approach to care includes experts in diagnosing, staging and treating cancer. Treatment plans are personalized based on your individual needs.