An Incentive for Colorectal Screening

January 4, 2018

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Colorectal cancer is the third most commonly diagnosed cancer in the United States. The 2017 estimate is 135,430 new diagnoses of colorectal cancer and 50,260 deaths. The goal for health care providers is to reduce these deaths through early detection. Colon polyps can develop over 10-15 years. When detected early, polyps can be removed reducing the risk of developing and dying of rectal or colon cancer. Early detection becomes your ally yet, only 60% of Americans who should get screened, do.

Generally, screening should begin at the age of 50 unless there is a family history or concerning personal history to begin earlier. Several screening tests are available. The choice of test should be determined during a routine appointment with your primary care provider. The tests range from simple in‐office exams to invasive procedures requiring sedation. The fecal occult blood test, recommended annually, is the easiest test performed in the physician’s office or the privacy of your home. A sample of stool is placed on a card and exposed to a solution that detects blood. The flexible sigmoidoscopy, recommended every five years, requires a bowel cleansing (prep) before the procedure. It can visualize up to two feet of the colon and rectum and allows removal of small polyps.

The colonoscopy, performed by a gastroenterologist, is the gold standard for colon screening and should be done every 5-10 years. It often requires a bowel prep the night before and morning of, which for many is the worst part of the procedure. A long, flexible tube is inserted into the anus and advanced through the entire colon. Small and medium sized polyps can be removed and sampled for evidence of colon or rectal cancers.

Get screened routinely. Early stage colorectal cancer many times has few to no symptoms.

Additional screening tests have emerged in the last 10 years including the CT colonography (virtual colonoscopy), a Fecal immune‐histochemical test (FIT), and Stool DNA testing. All three tests are less invasive than the colonoscopy and do not require a bowel prep. However, any abnormal findings will require a colonoscopy.

The patient’s goal should be to do what is necessary to avoid many trips to the local oncologist. My recommendation: Get screened routinely. Early stage colorectal cancer, which often has a better prognosis, many times has few to no symptoms.

I personally have a colonoscopy every five years. I have an electrical outlet in my bathroom and catch up on my DVD’s while I endure the prep!


Author: Bruce W. Porterfield, MD, PhD is a medical oncologist / hematologist at Arizona Oncology’s Green Valley office.

Categories: Cancer Screening