Screening for Colon Cancer

By Rishi Sharma M.D.

Since March is Colon Cancer Awareness Month, it is a good time to discuss colon cancer. Screening for colon cancer has the potential to save hundreds of thousands of lives in the next 15 years.

Colon cancer is the third most commonly diagnosed cancer and the second leading cause of cancer death in men and women combined in the United States. The American Cancer Society estimates that this year 136,830 people will be diagnosed and 50,310 will die from this disease.

Colon cancer is typically caused by polyps, which can be found and removed during a colon cancer screening. Everyone over the age of 50 should talk to their doctor about screening, even if they don’t have a family history of cancer. Why? Because in most cases, those diagnosed with colon cancer come from families that don’t have a history of colon cancer.

‍When caught early, colorectal cancer is often treatable. Removing polyps and catching cancer early is key.

If you are afraid to schedule a colon cancer screening because of the cost of the procedure, you don’t need to be. Under the Affordable Care Act, preventative care such as cancer screening is covered by your insurance. Your insurance may have specific rules about which method they cover. If you don’t have health insurance, there may still be help. The Colon Cancer Alliance provides financial assistance to those who cannot afford the cost of screening. Visit www.ccalliance.org/get-screened/resources/ for more information.

Here are a few questions I get asked often:

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What types of tests are there?

Stool tests: Stool tests can be completed at your own home. There are a variety of screening stool tests available, and it is recommended that you discuss various stool testing options with your physician.  Stool tests are significantly improving on detecting cancer, but still are not very good at detecting polyps.

Colonoscopy: A colonoscopy is an outpatient procedure where your doctor uses a lighted tube with a small camera to look inside your colon. This method is more involved than a stool test, but it is the single best test available to detect and remove polyps before they develop into cancer. Our bowel preparations are improving and the procedure is now typically done with anesthesia, which makes it pain-free.

CT colonography:  A CT scan can be used now to look for polyps as well.  It still requires a bowel preparation, however it can be used to detect polyps and is another option for patients for colon cancer screening.

Other tests are available, however these are a brief summary of the major screening tests.

How often should I be screened?

It depends on the test and the results of the test. Some tests require annual follow up, others require follow up every 10 years.

Who should be screened?

If you are over 50 years old, you should talk with your doctor about which screening method is best for you. If you are under 50 years old you should consult your doctor about if early screening is right for you, especially if you have a family history of colon cancer or polyps.  Family members with polyps have a higher risk of developing colon cancer and need to be screened earlier.

I’m under 50, but have noticed blood in my stools recently which I think is hemorrhoids, should I discuss this with my physician?

Yes, absolutely!  While in some cases it can be related to hemorrhoids, in certain cases it may be an early warning sign.  Research that was presented in February of 2017 found that 15% of new cases of colon cancer are people less than age 50.