Understanding Screening Options for Colorectal Cancer

March is colorectal cancer awareness month.

When there is an abnormal growth in the colon or rectum it is called colorectal cancer. The colon and rectum, which are commonly referred to as the large intestine, are the lower part of the digestive system, which processes food for energy and rids the body of solid waste. Colorectal cancer is the third most commonly diagnosed cancer in both men and women. 

Having polyps found early and removed from the colon or rectum keeps some people from getting colorectal cancer. In order to find polyps early, it is important to know when to get screened by your doctor. Starting at age 50, men and women who have average risk, age 45 for African Americans due to the slight increase in risk and age 40 for people with a family history of colorectal cancer diagnosed before the age of 60.

There are a few different screening tests that can be used to detect colorectal cancer. Your doctor can help determine which screening test is right for you. “Each test has its advantages and disadvantages, but the colonoscopy is the only test that is both a screening test and a therapeutic test,” says Dr. Nipun Reddy, Clinic Director in the UAB Division of Gastroenterology and Hepatology.

Screening test options include:

•          Colonoscopy- most comprehensive method and is recommended every 10 years
•          Fecal Immunochemical Test (FIT)- if this method is chosen it must be done annually
•         CT Colonography- if this method is chosen it must be done every 5 years
•          Stool DNA test (Cologuard)- if this method is chosen it must be done every 3 years

All of the above tests are approved for colorectal cancer screening. If any test comes back positive and/or irregular, a colonoscopy will be needed. More information on each test can be found here.

Risk factors for colorectal cancer:

•         Family history of colon cancer or polyps- One first degree relative (parents or siblings) diagnosed before the age of 60 or two second degree relatives (grandparent, uncle, aunt) diagnosed before the age of 60. 
•         Personal History of Inflammatory Bowel Disease (Crohn's and Ulcerative Colitis)
•        Age
•        Being overweight or obese
•         Physical Inactivity 
•         Diet high in red meats (beef, pork, lamb, liver) and processed meats (hot dogs and luncheon meats)
•         Smoking
•         Heavy Alcohol Use 

Talking with your doctor about colorectal cancer can be overwhelming. It is important to remember that this is their specialty and they are there to help you and provide guidance, expertise and advice.

“A conversation about colorectal cancer screening with your doctor should begin anytime and a careful review of family history will help determine if screening should begin sooner,” says Dr. Reddy.