March is National Colorectal Cancer Awareness month, a good time to highlight the importance of preventive screenings that decrease your risk of developing and dying from this all too familiar disease. Colorectal cancer is the third-most common cancer among men and women in the U.S. (not counting skin cancers), with more than 150,000 new cases and 52,000 deaths expected this year alone, according to the American Cancer Society.
Those numbers are scary, but it doesn’t have to be that way. Even though colorectal cancer, which is an abnormal growth of cells in the colon or rectum, is common, it is one of few cancers that can mostly be prevented through regular screenings and effectively treated when it’s detected early. Routine screenings based on your age and risk factors are the best way to monitor for and prevent colorectal cancer.
When should I get screened for colorectal cancer?
Prior to 2021, the American Cancer Society recommended that all Americans begin regular colorectal cancer screenings at age 50. But in May of 2021, the recommended age was dropped to 45 due to a significant increase in colorectal cancer rates among people under 55. Today, the American Cancer Society recommends that all Americans 45 years or older be screened for colorectal cancer.
If your father, mother, or siblings were diagnosed with colorectal cancer, you should start screening even earlier —10 years prior to the age your family member was diagnosed.
Colonoscopies: the gold standard
A colonoscopy is a procedure where doctors insert a small camera into the digestive tract to examine your colon and rectum. Colonoscopies make a lot of people nervous, but they’re the best screening method to detect and prevent colorectal cancer. The most uncomfortable part isn’t the procedure itself (you’ll be sedated); it’s preparing the day before by fasting and purging your digestive tract with laxatives.
Colonoscopies not only allow doctors to see any pre-cancerous changes in your colon and rectum, they also give doctors the opportunity to quickly and painlessly remove or treat any problematic polyps or lesions that could become cancerous. As an added bonus, this treatment is usually covered by insurance since it takes place during the preventative colonoscopy, and it will save you from having to come in for a second visit.
If the results of your colonoscopy show no polyps or other problems, you won’t need another scan for ten years. If your doctors do find precancerous abnormalities, they might recommend an alternative regimen that would require you to be screened every 1 to 5 years instead of every decade.
Screening for cancer at home
If the idea of a colonoscopy feels a little overwhelming, there are other options. Convenient, at-home test kits, like the one offered by Cologuard, include everything you need to collect a stool sample and mail it in for testing. These tests, which detect DNA and hemoglobin released from abnormal cells, are a legitimate replacement for routine colonoscopies, but with one caveat. If you do get a positive result, you’ll still need to schedule a follow-up colonoscopy to diagnose and potentially treat any changes in your colon or rectum.
There’s another take-home screening method called the FIT test, but it only detects hemoglobin (not DNA) in the stool, so it’s much less precise than other screening options. If you choose the FIT test as your screening method, you’ll need to take one every year, and you’ll still need a follow-up colonoscopy if you receive a positive result.
Screen your genes, too
Similar to the more well-known “breast cancer genes,” there are certain gene mutations that significantly increase the risk of developing colorectal cancer. These mutations can be passed down from one generation to another. If you have a history of colorectal cancer in your family, talk to your doctor, who may recommend a genetic screening. If the results indicate you’re at an elevated risk, your doctor may adjust your healthcare plan to include more frequent colonoscopies to more vigilantly screen for any signs of colorectal cancer.
There’s no getting around the fact that colorectal cancer, like all cancers, is terrifying to confront. But this is one cancer we’re lucky enough to be able to catch and treat early on. If you’re 45 years or older and haven’t been screened, don’t wait to go see your doctor. At least take an at-home test. It could very well save your life.
Justin Ebert, PA-C, is the medical director at MCHC Health Centers—a local, non-profit, federally qualified health center offering medical, dental, and behavioral health care to people in Lake and Mendocino Counties.