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Colorectal cancer is cancer that starts in either your colon or your rectum, which make up the lower part of your digestive tract. Regular colon screenings are crucial in preventing the development of colon cancer. The Multi-Society Task Force for colon cancer advises that most men and women begin screening for colon cancer at age 50. However, if you have a family history of colon cancer or are at high risk for other reasons, you may need to get screened earlier.
A colonoscopy is the gold standard for screening adults over the age of 50. However, in the event that you do not qualify for a colonoscopy, there are other screenings your doctor may recommend. Talk with your healthcare provider about the pros and cons of each test and which is best for your health needs.
Simple but more frequent: The stool test is probably the simplest test for colon cancer, since you can perform it at home with a kit from your healthcare provider. This method uses a specialized chemical to detect blood in the stool sample, which a doctor will test in the lab. Stool tests like Cologuard are recommended for individuals who are not good candidates for a colonoscopy. If you are at increased risk of colon cancer due to family history or present symptoms, skip this test and consult with your provider about your options. Colon stool screenings are typically performed once a year if the screening comes back clear.
Least invasive but less affordable: A virtual colonoscopy uses a CT scanner to take X-rays of your colon. A doctor will then analyze the images for any abnormalities. If you choose this route, the procedure is recommended to be repeated every five years. Keep in mind that if anything peculiar is found, your provider will most likely follow up with a physical colonoscopy.
More extensive but thorough: The sigmoidoscopy is one step down from a colonoscopy. This test requires a doctor to insert a short, flexible tube into the lower third of your colon to check for abnormal growths (polyps) or cancer. The test can vary depending on your condition and your healthcare provider's practices, but it typically does not require sedation. This procedure should occur every five years, but again, if any abnormalities are found, you will need a full colonoscopy.
Most in-depth and conclusive: During a colonoscopy, a doctor will use a long tube to check for polyps or cancer in the entire colon, rather than just the lowest third of your colon (like a sigmoidoscopy). Your provider may remove tissue or polyps for further examination and testing. If testing confirms the presence of precancerous cells, removing polyps is a preventative measure that eliminates the cancer’s progression. If needed, he or she may also treat other problems that are found, such as red or swollen tissue, open sores (ulcers) or bleeding. This is typically an out-patient procedure (meaning you don’t have to stay at the hospital overnight) and, depending on the results, is recommended every 5-10 years.
Observe National Colorectal Cancer Awareness Month this March by talking to a provider about your screening options. No matter which test your doctor recommends, the most important thing is that you get regular screenings. Some of these tests may be uncomfortable and even a little embarrassing, but it's important to keep in mind that colorectal cancer can often be easily treated — and even prevented — when caught early.
This article first appeared in the March 2020 edition of the HealthPerks newsletter.