March is Colon Cancer Awareness Month
Colorectal Cancer is Preventable: ACS recommends screening to start at 45
By finding and removing precancerous polyps (adenomas) that can develop into cancer, colorectal cancer can be stopped before it starts. In addition, screening for colon cancer can detect colorectal cancer early when it is most curable.
The American Cancer Society recommends that people at average risk of colorectal cancer start regular screening at age 45. This can be done either with a sensitive test that looks for signs of cancer in a person’s stool (a stool-based test), or with an exam that looks at the colon and rectum (a visual exam). The CDC recommends beginning at age 50, whether insurance will pay at 45 remains to be seen.
Traditional colonoscopy performed by gastroenterologist following bowel prep, or more recently, a highly accurate, non-invasive alternative is Cologuard, an at-home kit. Cologuard is a multitarget stool DNA test used in the Deep-C study. (In the Deep-C study, Cologuard demonstrated impressive sensitivities of 92% for CRC and 69% for adenomas with high-grade dysplasia. The specificity of Cologuard for individuals with normal colonoscopies was 90% i.e., 10% false-positives. Of note, because DNA undergoes methylation with normal aging, there are more false positives in older age groups. Actually, only 6% of individuals 50 to 65 years old had a false positive Cologuard. If Cologuard is performed every three years, the specificity and sensitivity should be even higher. (www.fda.gov).
People who are in good health and with a life expectancy of more than 10 years should continue regular colorectal cancer screening through the age of 75. For people ages 76 through 85, the decision to be screened should be based on a person’s preferences, life expectancy, overall health, and prior screening history. People over 85 should no longer get colorectal cancer screening.
All adults over the age of 45 are at risk for colorectal cancer and should be screened for adenomatous polyps and cancer. Some people have a greater-than-average risk and should work with their doctor to develop an individualized screening plan.
While over 90 percent of colon and rectal cancers are found in people over the age of 50, anyone at any age can get colorectal cancer. People younger than 50 need to protect themselves by knowing their family cancer history and their own medical history.
People with a family history of certain cancer or with certain medical conditions may need to begin colonoscopy screening earlier and be tested more often.
Risk factors for colon cancer:
Your risk of getting colorectal cancer increases as you get older. Other risk factors include:
- Inflammatory bowel disease, such as Crohn’s disease or ulcerative colitis.
- A personal or family history of colorectal cancer or colorectal polyps.
- A genetic syndrome such as familial polyposis or Lynch syndrome
Lifestyle factors that may contribute to an increased risk of colorectal cancer:
- Lack of regular exercise.
- A diet low in fruit and vegetables.
- A low-fiber and high-fat diet, or a diet high in processed meats.
- Overweight and obesity.
- Alcohol consumption.
- Tobacco use.
In addition, everyone, no matter how old they are, needs to know the signs & symptoms of colorectal cancer and have a complete colonoscopy to rule out cancer if they have symptoms.
Colorectal cancer symptoms:
- An ongoing change in bowel habits (diarrhea, constipation, or feeling that the bowel does not empty completely)
- Stools that are narrower than usual
- Blood (either bright red or very dark) in the stool (poop)
- Rectal bleeding
- Frequent gas pains, bloating, a feeling of fullness or abdominal cramps
- Weight loss for no known reason
- Feeling very tired (weakness and fatigue)