With Dr. Pamela Kunz
Colorectal Cancer Screening
What is the most important thing to know about Colorectal Cancer Screening?
The goal of routine colorectal screening is to prevent you from developing cancer or to diagnose it early when treatments are most effective. The best screening exam is the one that is completed. Screening is easy and has been proven to save lives. If you have any symptoms such as blood in stool or dark stools, abdominal pain, weight loss, or change in bowel habits, don't delay and share it with your doctor as more immediate attention might be needed.
Who should be screened for Colorectal Cancer?
All adults should be screened for colorectal cancer. The age to begin screening along with the risks and benefits of screen testing options depend on a number of individual factors such as your medical history and family history. You should discuss the timing and screening options that is best for you with your health care provider. If you have a family member such as sibling, parent, or children who had colorectal cancer or a pre-malignant colon polyp, you will be advised to undergo screening no later than age 40. Please share this information with your provider.
Who is at increased risk of colorectal cancer?
Some people are considered to be at increased risk of colorectal cancer more than the average person due to a personal or family history of cancer or pre-malignant colon polyps, known genetic mutations that are associated with colon cancer, personal history of inflammatory bowel.
Are you at average risk for colorectal cancer? If so, we recommend:
- Start colon cancer screening at age 45 by the type of screening test that would work best for you
- Continue with regular colon cancer screening until age 75 as long as you are healthy
- For people age 76-85, screening decision should be based on a personal preference, prior screening history and overall health. Those over 85 most likely do not benefit from having routine screening.
- Frequency of screening depends upon type of screening test used, the results of the previous testing, as well as family history
Are you at increased risk for colorectal cancer?
- Talk to your doctor about your risk factors, personal preferences, and whether a genetic evaluation would be appropriate for you.
- Colonoscopy is the preferred screening method for those at above average risk. Talk to your doctor to determine the appropriate age to start screening based on your risk factors
- Frequency of screening should be based on your risk of developing colorectal cancer and results of any previous colonoscopy
What types of tests are available for colorectal cancer screening?
Examination of the inside of the colon using a colonoscope- a flexible lighted thin tube like instrument, inserted into the rectum. It also has a tool to remove any abnormal tissue or growth found which can be examined for cancer under a microscope. It is performed with sedation so there is no pain during the procedure. The test is most effective when the colon is totally clear of stool which requires a liquid diet and bowel (prep) cleansing by laxatives one or two day before the procedure. Colonoscopy is not only a highly effective early detection tool, but it also the only test that can prevent colorectal cancer by removing small growths or polyps before they have the chance to become a problem.
Frequency: Once every 10 years if negative or sooner if indicated due to polyps or other risk factors
Stool Based Testing
Screening by stool testing is recommended for people at average risk of colorectal cancer. These tests can be done in the convenience of your home and does not require any changes in your diet, medications or a bowel prep. Stool based testing is generally not recommended to screen those at increased risk for colorectal cancer including patient with a personal history of polyps or cancers of the GI tract, family history of colorectal cancer, known genetic risk factors, inflammatory bowel disease, or with symptoms such as bleeding or anemia.
- Fecal Immunochemical Test (FIT): This test checks stool (solid waste) for blood. It is important to know that a positive test will require the patient to undergo a colonoscopy to determine if cancer or an advanced polyp is present. Frequency: Once every year if negative
- Multitargeted Stool DNA Test: This test checks stool (solid waste) for blood as well a certain DNA markers that are associated with colorectal cancer and polyps. It is important to know that a positive test will require the patient to undergo a colonoscopy to determine if cancer or an advanced polyp is present. Frequency: Once every three years if negative
Similar to a colonoscopy, this test uses a flexible lighted tube inserted into the rectum but it only examines the lower part of the colon. This generally requires less anesthesia and a bowel prep is required.
Frequency: Once every 5 years if negative. Once every 10 years if combined with yearly FIT test.
This is a specialized CT scan used to evaluate the lining of the colon for growths or polyps. A bowel cleansing is required for this test. A follow up colonoscopy will be recommended for removal of any polyp detected during this test.
Frequency: Once every 5 years if negative
With Dr. Pamela Kunz