Colorectal Cancer: Screenings Are Crucial


March is National Colorectal Cancer Awareness Month. Colorectal cancer refers to cancer that forms in the colon or the rectum. It is the second leading cause of cancer death in the United States. Yet it is also a slow-growing, very treatable disease. One key way to lower your risk of death from this cancer is to get screened for it.

Colorectal cancer is most likely to affect your bowel movements. You may have diarrhea or feel constipated. You may also have an urge to have a bowel movement that doesn’t pass even after you’ve gone to the bathroom. Other common symptoms include rectal bleeding and blood in your stool. You may feel cramps or pain in your abdomen. You may feel tired and weak. And you may have unexplained weight loss.

Yet there are often no symptoms at all in the early stages. That is why getting screened is so crucial. Screening tests can look for cancer and help catch it early on, when it is very curable. Tests may also look for polyps. These are growths on the lining of your colon or rectum that may turn into cancer someday. Screenings can find and remove polyps early, before that happens. There are 2 main types of tests, and there are different screening options for each type.

Direct visualization tests allow your doctor to view your colon and rectum with the use of cameras or x-rays. The main benefit of these tests is that they can screen for both polyps and cancer. In some cases, your doctor can even sample or remove suspicious polyps on the spot. And you only need to get these tests done every 5 to 10 years.

As for drawbacks? These tests are somewhat invasive. Before the test, you may have to fast, follow a special diet, or take a laxative. This is known as bowel prep. It helps clean out your colon, which helps your doctor have a clearer view. You may find both the prep for the test and the test itself unpleasant. In some cases, you may need to be sedated. And these tests can carry some risks. This is true especially for older adults.

Screening options for this type of test include the following:

  • Colonoscopy
  • Flexible sigmoidoscopy
  • CT Colonography (Virtual Colonoscopy)
  • Double-Contrast Barium Enema (DCBE)

Stool-based tests look for hidden blood or for cells with DNA mutations in your stool. These may be signs of the presence of cancer or polyps. There are a few main benefits of these tests. They are less invasive. They can be done in the comfort of your own home. And while you may have to avoid certain foods or drugs before the test, you don’t need any bowel prep. You also don’t need to be sedated. And there are no real risks.

As for the drawbacks? These tests are less effective. They may not catch some polyps or cancer. They may produce false-positive results. Plus, they need to be done every 1 to 3 years. And if the tests ever indicate cancer, you’ll need a colonoscopy.

Screening options for this type of test include the following:

  • Guaiac-based fecal occult blood test (gFOBT)
  • Fecal immunochemical test (FIT)
  • Stool DNA test

For most people, doctors recommend that you start to get screened for colorectal cancer at age 50. And continue to get screened through the age of 75. Talk with your doctor to see if you need to continue screenings after the age of 75. Also, talk with your doctor to see if you have a high risk of colorectal cancer. If so, you may need to start screening earlier or get screened more often.

Screening for colorectal cancer is very effective. Research has shown that it can greatly reduce the risk of dying from the disease for people between the ages of 50 and 75. Yet many people do not get screened. The unpleasantness and the possible risks of certain tests may play a role. The good news is that there are many screening options. Some are far less invasive and have fewer risks. Though not all screening options are equally effective, anything is better than not getting tested at all. Talk with your doctor to discuss your risk factors and to discuss these and other screening options that are best for you.