The Importance of Colon Cancer Screening for Adults 45 and Older
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Colon cancer remains the third-leading cause of deaths related to cancer in the United States. While the death rate is dropping for older adults since the advent of screening, the disease is killing more individuals under the age of 55 than ever before. That’s why it’s important to know when to start colon cancer screening, which can detect signs of cancer at its earliest, most treatable stages or even prevent it altogether.

Timely screening can prevent colon cancer or find it when it’s more easily treated.

Colon polyps are noncancerous growths that can form in the colon. Left undetected over time, some of these polyps can develop into cancer. Fortunately, colon cancer screening using colonoscopy can find these abnormal growths and also remove them during the same procedure. This eliminates the possibility that they could potentially turn into cancer in the future.

With regular screening, you also increase your chances of detecting colon cancer early before it has time to spread outside of the colon. While a diagnosis may feel surprising, early stages of colon cancer are generally easily cured. In fact, the five-year survival rate for colon cancer contained to the colon exceeds 90 percent, according to the American Cancer Society. In contrast, delayed screening increases your risk of letting colon cancer go undetected and progressing to later stages that are much harder to treat.

Everyone 45 and older with an average risk should be screened for colon cancer.

Colon cancer screening is a test used to look for signs of pre-cancer or cancer in the colon before symptoms appear. Because people with early stages of colon cancer may not experience any signs of the disease, it’s important to begin screening on time so that you have the best chance for detecting anything concerning early. Since more adults are being diagnosed with colon cancer at younger ages, the recommended age for the start of screening lowered to age 45 in 2018. It’s important to know that this recommendation is for both men and women with an average risk, or no personal or family history of the disease. 

Consider your own risk factors to determine the right time to begin screening.

If you have a history of colon polyps or cancer or you have an immediate family member, like a parent or sibling, who has been diagnosed with colon cancer, you may have an increased risk of developing the disease. Your risk of colon cancer may also be higher than average if you have certain illnesses that affect the colon, such as Crohn’s disease or ulcerative colitis. If you are considered “high risk”, you should talk to your doctor about the best time to begin screening, as you may benefit from earlier or more frequent screening tests. 

Colon cancer screening options and choosing the right test.

There are many different screening tools, and while some offer advantages over others, the most important thing is to get screened. Consider asking your doctor about the pros and cons of each of the following screening tests to determine which may be the best fit for you.

Colonoscopy remains the gold standard for colon cancer screening.

A colonoscopy is the most well-known screening test, as it’s the only one used to both detect and prevent colon cancer. It’s a low-risk, same-day procedure that allows your doctor, a gastroenterologist, to view the inside of the colon and rectum. Using a colonoscope, a small, flexible tube with a camera on the end, your doctor can pass small instruments through the colonoscope to remove anything suspicious, like polyps, when necessary.

Before the test, you’ll need to follow instructions for bowel preparation (prep), which will ensure your doctor can see the entire colon lining during the test. There are different prep protocols depending on your health and where you’re having it done. Many people are relieved to know that colonoscopy prep is much easier and better tolerated than it used to be. If you choose to have a colonoscopy, a normal test result means you can wait ten years to get screened for colon cancer again. If you choose a stool or DNA-based test, you’ll need to repeat it every one to three years, depending on the test and your risk factors. 

Stool testing.

Stool-based tests evaluate stool samples for abnormalities that may indicate signs of cancer. These tests include:

  • Fecal immunochemical tests (FIT) which look for hidden blood in the stool
  • Stool DNA tests, such as Cologuard, which analyze stool for both hidden blood and abnormal DNA from cancer or polyps

These are safe, FDA-approved methods for detecting colon cancer, and some people find them more convenient because they can be done at home. However, there are several disadvantages to stool-based colon cancer screenings. They need to be done more frequently than colonoscopies, and if you receive a positive result that indicates something suspicious, you’ll need to have a colonoscopy as well, for further evaluation.

Other visual screening tests.

In addition to colonoscopies, there are other tests that use different imaging technologies or tools to view the inside of the colon. These include:

  • CT colonography (virtual colonoscopy): This test uses computed tomography (CT scan) to produce a 3D picture of the inside of the colon and rectum. It’s important to know that while this test doesn’t require any sedation, it does still involve bowel prep beforehand. And if anything suspicious is found, you’ll need a colonoscopy so your doctor can get a better look.
  • Sigmoidoscopy: Similar to a colonoscopy, a sigmoidoscopy involves using a thin, flexible tube attached to a small camera to view the inside of the colon. However, this test only allows your doctor to view and remove polyps in the lower part of the colon. Like a colonoscopy, it involves some bowel prep so the colon and rectum are empty during the test. And, like other tests, your doctor will still need to perform a colonoscopy if a precancerous polyp or cancer is found.

Don’t delay, schedule your colon cancer screening today.

The first step to protect yourself against colon cancer is to talk to your doctor about your screening options and when to start. If you have an average risk of colon cancer, begin screening at 45 to increase your chances of detecting, or even preventing, colon cancer.

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