Why is colon cancer screening important?
Colorectal cancer (cancer of the large intestine) is the second leading cause of cancer deaths in the United States where it will likely cause over 50,000 deaths in 2023. These cancers typically start out as small growths in the colon. If the polyps are identified and removed at this stage, they are harmless. However, if they are not removed they can progress to cancer, which can spread to other parts of the body, be much more difficult to treat and lead to serious illness and death. Although colon cancer can cause symptoms like blood in the stool, weight loss, stomach or abdominal pain, or changes in stool shape or consistency, these symptoms often do not happen until the polyps or cancer have progressed and become more difficult to treat or even life-threatening. To prevent this from happening, it is very important to find these polyps and remove them before they have the chance to turn into cancer and to identify any cancers as early as possible.
When should I start to get screened?
In the past, we have generally suggested that patients start screening for colon cancer at age 50 (or earlier if there are concerning symptoms or other risks like family history). However, in the past several decades, there has been a significant increase in colon cancer in patients under the age of 50. This has several organizations including the American Cancer Society (ACS) and the United States Preventative Task Force (USPSTF) suggest that patients start screening at age 45. However, if you have a family history, or other symptoms be sure to discuss them with your primary care doctor, as you may need testing sooner than age 45.
How can I check for colon cancer?
There are several ways to test for colon cancer. The most common way to be screened is with a colonoscopy. During a colonoscopy, you are given sedation to make you very sleepy and relaxed. Then a long, thin camera called a colonoscope is inserted to the colon and used to look for any polyps or cancers. The camera can also be used to remove polyps. Prior to the colonoscopy, you will be asked to “prep” using laxatives to clean out the colon prior to the procedure. Many patients find that this is the most difficult part of the entire procedure. Because a colonoscopy is a procedure there is a small risk of problems from the medications used for prep or during the procedure or of damaging the colon during the procedure.
There are also non-invasive tests to look for colon cancer. One test that has become more common lately is the Cologuard test which looks for signs of polyps or cancer in the stool. This test is less invasive than a colonoscopy but does have some drawbacks. It should not be used for patients who have risk factors for colon cancer such as a personal or family history of colon cancer or certain types of polyps. It can also miss a small number of polyps or cancers, and if the test is abnormal, you will still need a colonoscopy to identify the problem.
How often should I be screened and when should I stop screening for colon cancer?
If your colonoscopy is normal, and you do not have any other risk factors for colon cancer, you should have repeat screening in 10 years. If you have a normal Cologuard test you should be tested again in 3 years.
Currently, most groups suggest stopping colon cancer screening at age 75. However, additional tests may be suggested if a patient has a family history of colon cancer, or if previous tests were abnormal.
To learn more about or to schedule a colorectal cancer screening please visit https://www.carenewengland.org/schedule-a-colonoscopy.
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