By Mountain-Pacific Quality Health
March 30, 2023
The rate of new colorectal cancer cases in America has declined over the past 20 years, but it is still the second most common cause of cancer death in America. It is also the third most common cancer worldwide. Despite the prevalence of colorectal cancer, many Americans avoid life-saving screenings that can catch cancer early or even before it starts.
What is colorectal cancer?
Colorectal cancer is any cancer that forms in either the colon or rectum. It can occur in those as young as teenagers, but the chance of getting colorectal cancer increases with age. While regular screenings were recommended for people aged 50 or older, a spike in cancer cases of those younger than 50 led the U.S. Preventive Services Task Force (USPSTF) to lower the recommended colorectal cancer screening age to 45.
What causes it?
Most colorectal cancers begin as small growths called polyps. These growths appear on the inner lining of the colon or rectum. Over time, polyps can develop into cancer, but not all will.
What are the risk factors and signs?
There are several risk factors for developing colorectal cancer, getting older being one of the greatest. Other risk factors include
- having a history of colorectal cancer in a first-degree relative,
- having three or more alcoholic drinks a day,
- smoking cigarettes,
- obesity,
- being Black.
Signs and symptoms of colorectal cancer can include
- blood (bright red or very dark) in the stool,
- weight loss for no known reason,
- feeling very tired,
Visit the National Cancer Institute for more risk factors and symptoms of colorectal cancer. Talk to your doctor if you are experiencing any of these symptoms or if you think you might be at an increased risk of colorectal cancer.
What are the screening methods?
With a 98% accuracy rate, the colonoscopy is the best screening method for colorectal cancer. During a colonoscopy a long, flexible tube (colonoscope) is inserted into the colon through the rectum of a sedated patient. A light and small camera on the end of this tool allows a doctor to look inside the colon for polyps or other abnormalities. Special instruments can also be threaded through the colonoscope. In this manner, polyps found during the procedure can be biopsied or removed. The USPSTF recommends people in good health should get their first colonoscopy at age 45 and then every 10 years. People at higher risk for colorectal cancer may need to get screenings more often.
Colonoscopies may not be the best option for everyone. Many Americans forego this screening for a number of reasons, including
- uncomfortable bowel preparation,
- fear of sedation,
- required fasting,
- taking time off work,
- lack of transportation.
A better option for some is a CT colonography, or virtual colonoscopy. A virtual colonoscopy uses X-rays to image the colon. A doctor then examines the images for any polyps or abnormalities. This screening method does not require sedation, but bowel prep is still necessary. It is much less invasive than a colonoscopy, but a colonoscopy will still be required if the doctor finds any anomalies. The USPSTF recommends those 45 and older at average risk for colorectal cancer should have a virtual colonoscopy every five years.
The fecal immunochemical test, or FIT, is an at-home colorectal screening option. With this test a small amount of fecal matter is collected and sent to a lab for analysis. Antibodies detect blood in the stool to determine if colorectal cancer is present. Despite its convenience, this method has several drawbacks. The FIT is only 79% accurate and is prone to false positives. A colonoscopy is also required if a FIT comes back positive. The USPSTF recommends the average person 45 and older gets a FIT every year.
Visit the Centers for Disease Control and Prevention for information on several other colorectal cancer screening tests. Speak with your doctor about which option is right for you.
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