Cancer
Colorectal cancer is one of the most common cancer diagnoses for men and women in the United States, but it can be very successfully treated when caught early. Despite this, colorectal cancer continues to be the second most common cause of cancer death in the country, according to the American Cancer Society.
This March, which is Colorectal Cancer Month, Fayetteville Gastroenterology Associates Gastroenterologist John Poulos, M.D., has an important message for people who have been putting off their screening: For your health and your peace of mind, get screened sooner rather than later.
For people who are in good health and at average risk, the American Cancer Society recommends screening beginning at age 45 and then once every 10 years if there are no other indications. After age 75, screening becomes something that should only be done as needed, based on individual circumstances and health history.
Colorectal cancer starts in the colon or the rectum, and often produces no early symptoms. Most colorectal cancers start as a polyp, a growth on the inner lining of the colon or rectum. The gold standard for screening for these polyps is a colonoscopy because during the procedure, if a precancerous polyp is found, it can be removed. Symptoms of colorectal cancer include new abdominal pain or weight loss, blood in or on the stool, as well as other changes in stool and bowel habits.
African Americans are at increased risk for colorectal cancer, though Dr. Poulos points out that socioeconomic disparities may play a role in the increased risk. Decreased access to care, and failure of early detection and treatment means worse outcomes. African and Hispanic Americans are less likely to be able to get prompt follow-up after an abnormal screening result, so they are more likely to be diagnosed with late-stage cancer.
“However, with regular screenings, colorectal cancer is one of the most preventable forms of cancer, because we can remove the precancerous lesions before they turn into cancer,” he said.
Dr. Poulos emphasizes that everyone should follow the guidelines and get their screenings starting at age 45.
“People should try to get a colonoscopy, because it’s the only screening that is also preventative,” Poulos said. “However, any screening is better than no screening at all. There are several types of non-invasive screening kits that are marketed to the public. These are only for people who are at average risk.”
Dr. Poulos also points out that when at-home screening kits are positive, that indicates that a colonoscopy is still needed. If a person has used an at-home test, then the follow-up colonoscopy is often no longer covered as a free annual screening under their insurance. If the patient initially undergoes screening with colonoscopy, then that is considered preventative screening and is fully covered by most insurance.
“The cost for one colonoscopy every ten years is less than three at-home test kits in the same period,” Poulos said. “The at-home tests are only good for three years before you need another one, because they are not as good of a screening tool as a colonoscopy.”
It’s understandable why most people aren’t excited to get a colonoscopy, but there is good news for people who have been avoiding getting screened because of fear of the procedure.
“The preparation process for colonoscopies has gotten a lot better than it used to be,” Dr. Poulos said. “And the anesthesia we use is much better, too. Just like other screening measures to keep you healthy, remember to get a colonoscopy when it’s time. This is one of few tests that have been shown to prevent cancer. Unfortunately, only 30 to 40 percent of patients who are eligible for colorectal cancer screenings are actually being screened.”
SIDEBAR
Know your risk factors
Colorectal cancer risk factors you can change:
- Being overweight
- Not being physically active
- Diets high in red meats and processed meats
- Smoking
- Alcohol use
Colorectal cancer risk factors you cannot change:
- Being older
- A personal history of colorectal polyps or colorectal cancer
- A personal history of inflammatory bowel disease
- A family history of colorectal cancer
- Racial and ethnic background – African Americans have the highest colorectal cancer incidence and mortality rates of all racial groups in the US
- Jews of Eastern European descent (Ashkenazi Jews) have one of the highest colorectal cancer risks of any ethnic group in the world
- Having type 2 diabetes
BREAKOUT BOX
The COVID-19 pandemic has resulted in many elective procedures being put on hold, and this has led to a substantial decline in cancer screening. Health care facilities are providing cancer screening during the pandemic with many safety precautions in place. Talk to your doctor about what steps you can take to plan, schedule, and get your regular cancer screenings.
