By Lisa Coon, OSF HealthCare
Need a reason to stop avoiding colorectal cancer screenings?
We’ve got several: A colorectal cancer diagnosis is the third most common cancer diagnosis in men and women in the United States and the second leading killer. About 50,000 people die each year—even though it’s the most treatable cancer when detected early.
How can colorectal cancer be prevented? Colon cancer is slow growing and often develops from polyps. One way to prevent colon cancer is to find any polyps and remove them before they develop into cancer and spread into nearby lymph nodes.
But if all that is not enough—we get it. The idea of a colonoscopy is not a comfortable one. The good news: There are more screening options than ever before.
What Are My Options?
Colonoscopy
A colonoscopy is the gold standard for colon cancer screenings. The procedure involves inserting a colonoscope into the rectum. The colonoscope allows the doctor to view the entire length of the colon and rectum, take tissue samples, and remove any polyps—small growths that can develop into colorectal cancer. A clear liquid diet and colon cleanse are required the day before. You are sedated during the procedure. The test is done every 10 years or more frequently based on the findings. Colonoscopies prevent colon cancer by finding polyps and early signs of colorectal cancer when there are more treatment options.
CT Colonography (virtual colonoscopy)
A CT colonography uses X-rays and CT scans to make 3D images of the colon and rectum. If something abnormal, like polyps or tumors, is found, you will need a colonoscopy. Unlike a colonoscopy, CT colonography doesn’t require sedation or instrument insertion into the rectum or colon. It does require a clear liquid diet and colon cleanse the day before. The test is repeated every five years or more based on the findings.
Stool DNA Test
Currently, the only stool DNA test approved by the US Food and Drug Administration (FDA) is called Cologuard®. With a colon cancer home screening kit, you’ll get a kit in the mail for collecting a stool sample. It’ll have detailed instructions and everything needed to collect and ship the sample. The test looks for abnormal sections of DNA that are shed from cancer or polyps. No drug or dietary restrictions are needed. If something is detected, a colonoscopy will be needed. If normal, the test is repeated every three years.
Fecal Immunochemical Test (FIT)
This colon cancer at-home test looks for microscopic, hidden blood in the stool. Small amounts of stool are collected on cards or tubes for this test. Sometimes these tests can show a polyp or cancer when there isn’t—a false positive. They can also miss a polyp or cancer cells if they don’t bleed—a false negative. There are no drug or dietary restrictions the day before the test. If the result is positive, a colonoscopy will be needed. This test is repeated yearly.
Fecal Occult Blood Test (FOBT)
Like the FIT at-home test, this test detects blood in the stool through a chemical reaction. You will need to collect three samples and return them to your primary care provider for testing. While this test can detect blood, it can’t tell where it originated, possibly leading to a false positive result. There are drug or dietary restrictions the day before the test. To reduce false positives, read and follow all of the instructions. If the result is positive, a colonoscopy will be needed. This test is repeated yearly.
When Should I Get Screened?
The American Cancer Society now recommends that people start colon cancer screening guidelines at age 45 instead of 50, earlier if they have any of these colorectal cancer risk factors:
- A personal or family history of certain growths, called polyps, or colorectal cancer
- Inflammatory bowel disease
- Certain genetic syndromes
Some at-home tests are new and still being developed. Insurance coverage varies. You should contact your insurance provider to determine if the product is and at what age your coverage begins.
A Few Words on Cancer Prevention
It’s best to be proactive when looking for ways to prevent colon cancer. A colon cancer prevention diet can reduce the risks of a family history of colorectal cancer. You should not just avoid foods that might raise your risk but eat foods that help to prevent colon cancer, such as foods high in fiber.
“The best test is the one that gets done, whether stool-based or colonoscopy,” said Dr. Omar Khokhar, gastroenterologist at OSF HealthCare. “If you have family members with a history of colorectal cancer, it’s essential to have that conversation.”
To learn more, visit OSFHealthCare.org.