Colorectal Cancer Screening

A colonoscopy can actually prevent cancer since it can lead to the detection and removal of polyps, some of which may progress to cancer. The American Cancer Society expects more than 50,000 people to die of the disease this year, yet only 60 percent of those who should have a colonoscopy have had one. Doctors recommend a colonoscopy for people over 45 years old.

What Is Colorectal Cancer Screening?

A screening test is used to look for a disease when a person doesn’t have symptoms.  When a person has symptoms, diagnostic tests are used to find out the cause of the symptoms. 

Colorectal cancer almost always develops from precancerous polyps (abnormal growths) in the colon or rectum. Screening tests can find precancerous polyps, so that they can be removed before they turn into cancer. Screening tests can also find colorectal cancer early, when treatment works best.

Screening Guidelines

Regular screening, beginning at age 45, is the key to preventing colorectal cancer. The U.S. Preventive Services Task Force (USPSTF) recommends that adults age 45 to 75 be screened for colorectal cancer, and that adults age 76 to 85 ask their doctor if they should be screened.

When Should I Begin to Get Screened?

You should begin screening for colorectal cancer soon after turning 45, then continue getting screened at regular intervals. However, you may need to be tested earlier than 45, or more often than other people, if-

• You or a close relative have had colorectal polyps or colorectal cancer.
• You have an inflammatory bowel disease such as Crohn’s disease or ulcerative colitis.
• You have a genetic syndrome such as familial adenomatous polyposis (FAP) or hereditary non-polyposis colorectal cancer (Lynch syndrome).

If you think you are at increased risk for colorectal cancer, speak with your doctor about when to begin screening, which test is right for you, and how often to get tested.

Free or Low-Cost Screening

Six states in CDC’s Colorectal Cancer Control Program provide colorectal cancer screening to low-income men and women aged 45 to 64 years who are underinsured or uninsured for screening, when resources are available and there is no other payment option.

Colorectal cancer screening tests may be covered by your health insurance policy without a deductible or co-pay.

Screening Tests 

Several screening tests can be used to find polyps or colorectal cancer. The Task Force outlines the following colorectal cancer screening strategies. Talk to your doctor about which of the following tests are right for you.

Stool Tests

• The guaiac-based fecal occult blood test (gFOBT) uses the chemical guaiac to detect blood in the stool. It is done once a year. For this test, you receive a test kit from your health care provider. At home, you use a stick or brush to obtain a small amount of stool. You return the test kit to the doctor or a lab, where the stool samples are checked for the presence of blood.
• The fecal immunochemical test (FIT) uses antibodies to detect blood in the stool. It is also done once a year in the same way as a gFOBT.
• The FIT-DNA test (also referred to as the stool DNA test) combines the FIT with a test that detects altered DNA in the stool. For this test, you collect an entire bowel movement and send it to a lab to be checked for cancer cells. It is done once every one or three years.

Flexible Sigmoidoscopy

For this test, the doctor puts a short, thin, flexible, lighted tube into your rectum. The doctor checks for polyps or cancer inside the rectum and lower third of the colon.

How often: Every 5 years, or every 10 years with a FIT every year.

Colonoscopy

This is similar to flexible sigmoidoscopy, except the doctor uses a longer, thin, flexible, lighted tube to check for polyps or cancer inside the rectum and the entire colon. During the test, the doctor can find and remove most polyps and some cancers. Colonoscopy also is used as a follow-up test if anything unusual is found during one of the other screening tests.

How often: Every 10 years.

CT Colonography (Virtual Colonoscopy)

Computed tomography (CT) colonography, also called a virtual colonoscopy, uses X-rays and computers to produce images of the entire colon, which are displayed on a computer screen for the doctor to analyze.

How often: Every 5 years.

How Do I Know Which Screening Test Is Right for Me?

There is no single “best test” for any person. Each test has advantages and disadvantages. Talk to your doctor about the pros and cons of each test, and how often to be tested. Which test to use depends on—

• Your preferences.
• Your medical condition.
• The likelihood that you will get the test.
• The resources available for testing and follow-up.

More Information

• Final Recommendation Statement: Colorectal Cancer Screening (U.S. Preventive Services Task Force)
• Screening for Colorectal Cancer: Consumer Guide (U.S. Preventive Services Task Force)

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Please contact Lake Russell Specialty Healthcare Service at (706) 213-2580 or your primary care provider to take action.