By Bonnie McReynolds, ARNP
Happy March! A time to celebrate daffodils, longer daylight and colorectal cancer screening. Yes, colorectal cancer screening is something to be celebrated!
Worldwide, colon cancer is the second most common cancer diagnosis in women and third most common in men. In the United States, it is the second leading cause of cancer related deaths. In 2012 alone, 694,000 people died of colon cancer. In our lifetime, we have a 4.4% likelihood of developing colon cancer. So, it is both common and lethal.
Colorectal cancer screening, like other popular screening tools, such as pap smears and mammograms, aims to identify early stage cancers. If caught early, progression and death can be prevented. Over the past 15 years the US has seen a consistent annual drop of about 2.7% in the number of deaths from colon cancer and an estimated prevention of colon cancer development from lesion, from 250,000 to 500,000 cases. This drastic reduction is due to improved screening tools and a higher rate of people completing recommended screenings. This is something worth celebrating!
Colon cancer develops from polyps, which are growths on the inside walls of the colon. There are several types of polyps (adenomas and hyperplastic), only adenomas are precancerous. Adenomas make up two thirds of all polyps, and look like skin tags on the walls of the colon. They are considered precancerous, meaning over time they will develop into cancer.
Nonpolypoid adenomas, are a type of adenoma that are also precancerous. Their appearance is flat or indented, and they make up about a third of adenoma lesions. Hyperplastic polyps, make up the remainder of polyps found and are not cancerous, nor do they develop into cancer. Adenomas and hyperplastic polyps look the same on exam, and can only be distinguished by removal and close examination.
The goal of screening is to detect these lesions early on and prevent them from progressing to cancer. But who and when do we screen and what options do we have in screening tools?
It is recommended that patients begin talking about their risk factors with their provider at age 20 and begin screening at t 50 years of age. There are some individuals that may need to begin screening earlier, including those with immediate family with a history of colon polyps or colon cancer or those with other identified risk factors. African Americans should consider screening earlier, at age 45, due to a higher rate of colon cancer. Those with a personal history of radiation treatment for prostate cancer, endometrial cancer prior to age of 50 years of age or those with HIV should also consider early screening.
There are 3 main types of colorectal cancer screening tests including colonoscopy, flexible sigmoidoscopy, and stool tests. All tests are acceptable options, each with its own pros and cons. The best test is the one that the individual is willing to do.
So, celebrate spring—and talk to your healthcare provider about your personal risk factors and options in in colon cancer screening. Like other preventative measures, the goal is to identify a problem early and prevent progression that in this case can be life threating. Celebration is in the prevention!
Below is a list of questions you can ask you provider at your next appointment:
- What is my risk for colorectal cancer?
- When do you recommend that I start getting tested and how often?
- What are the different types of screening tests available to me?
- Which screening test do you recommend? Why?
- What happens during the screening? How do I prepare?
- Are there any dangers or side effects of screening?
- How long will it take to get the results?
- What can I do to reduce my risk of colorectal cancer?