During Colon Cancer awareness month there is a lot of emphasis on Colon Cancer Screenings, but who should take part? At what age? Under what circumstances? The National Cancer Institute breaks down the screening criteria and methods for us:
People at average risk of colorectal cancer get screened at regular intervals beginning at age 50 years. The USPSTF recommends that screening continue to age 75 years; after age 75, the decision to screen is based on patient’s life expectancy, health status, comorbid conditions, and prior screening results. Routine screening of people aged 86 years or older is not recommended by the USPSTF.
People at increased risk because of a family history of colorectal cancer or polyps or because they have inflammatory bowel disease or certain inherited conditions may be advised to start screening before age 50 and/or have more frequent screening.
Many patients assume a Colonoscopy is the only way to screen for Colon or Rectal Cancer, but actually many screening options exist based on a patient’s circumstance, symptoms, age and so forth. Here are a few options and how they work:
High-sensitivity fecal occult blood tests (FOBT). Both polyps and colorectal cancers can bleed, and FOBT checks for tiny amounts of blood in feces (stool) that cannot be seen visually.
Guaiac FOBT uses a chemical to detect heme, a component of the blood protein hemoglobin. Because the guaiac FOBT can also detect heme in some foods (for example, red meat), people have to avoid certain foods before having this test.
*Studies have shown that guaiac FOBT, when performed every 1 to 2 years in people aged 50 to 80 years, can help reduce the number of deaths due to colorectal cancer by 15 to 33%.
Stool DNA test (FIT-DNA). The DNA comes from cells in the lining of the colon and rectum that are shed and collect in stool as it passes through the large intestine and rectum. As with both types of FOBT, the stool sample for the FIT-DNA test is collected by the patient using a kit; the sample is mailed to a laboratory for testing. A computer program analyzes the results of the two tests (blood and DNA biomarkers) and provides a finding of negative or positive. People who have a positive finding with this test are advised to have a colonoscopy.
Sigmoidoscopy. In this test, the rectum and sigmoid colon are examined using a sigmoidoscope, a flexible lighted tube with a lens for viewing and a tool for removing tissue. During sigmoidoscopy, abnormal growths in the rectum and sigmoid colon can be removed for analysis (biopsied). The lower colon must be cleared of stool before sigmoidoscopy, but the preparation is less extensive than that required for colonoscopy. People are usually not sedated for this test.
*Studies have shown that people who have regular screening with sigmoidoscopy after age 50 years have a 60 to 70% lower risk of death due to cancer of the rectum and lower colon than people who do not have screening.
Standard (or optical) colonoscopy. In this test, the rectum and entire colon are examined using a colonoscope, a flexible lighted tube with a lens for viewing and a tool for removing tissue. Like the shorter sigmoidoscope, the colonoscope is inserted through the anus into the rectum and the colon as air (or carbon dioxide) is pumped into the colon to expand it so the doctor can see the colon lining more clearly. During colonoscopy, any abnormal growths in the colon and the rectum can be removed, including growths in the upper parts of the colon that are not reached by sigmoidoscopy. A thorough cleansing of the entire colon is necessary before this test. Most patients receive some form of sedation during the test.
*Studies suggest that colonoscopy reduces deaths from colorectal cancer by about 60 to 70%. Experts recommend colonoscopy every 10 years for people at average risk as long as their test results are negative.
Virtual colonoscopy. This screening method, also called computed tomographic (CT) colonography, uses special x-ray equipment (a CT scanner) to produce a series of pictures of the colon and the rectum from outside the body. A computer then assembles these pictures into detailed images that can show polyps and other abnormalities. Virtual colonoscopy is less invasive than standard colonoscopy and does not require sedation. If polyps or other abnormal growths are found during a virtual colonoscopy, a standard colonoscopy is usually performed to remove them.
If you think you are at higher risk, have a family history of Colon or Rectal Cancer, have been having chronic symptoms or are at the recommended screening age visit Dr. Margarita Murphy at Colon Surgeons of Charleston and take a proactive approach to your health.
1439 Stuart Engals Blvd Ste. 100
Mt Pleasant, SC 29464