Colorectal cancer: How and when to get screened


by Melvin Simien, MD

Nov 30, 2020

Did you know that colorectal cancer is the third most common form of cancer for both men and women? Though colon cancer and rectal cancer are oftentimes very treatable if caught in the earliest stages, it is extremely important for us all to be knowledgeable of the associated cancer symptoms, signs, risk factors and screening guidelines.

Follow along to find out how to decrease your cancer risk by taking preventative measures against colon and rectal cancers.

Colorectal cancer 101

Common symptoms and signs

Though colorectal cancer does not necessarily present signs or symptoms, there are certain health changes that should alert you to seek medical attention with a gastroenterologist, including:

  • Change in the shape or size of the stool
  • Change in frequency of the stool
  • Blood in the stool
  • Weight loss 
  • Abdominal pain 

If you experience any of these changes, talk to your primary care doctor or a gastroenterologist. While these symptoms could be the result of a number of different health factors or conditions, it’s important to get checked out to make sure they are not signs of colon or rectal cancer.

Colorectal cancer risk factors 

Individuals with family history of colon cancer, family history of colon polyps, personal history of colon polyps, pre-existing conditions such as inflammatory bowel disease, poor dietary choices and lack of physical activity are considered most at risk for colon cancer.

What are colon polyps? 

Polyps are growths of tissues or cells that have grown toorapidly. Many times, polyps are benign, but if they are left unchecked, polyps have the potential to become precancerous and then develop into cancer. This is where regular screening is key — identifying and removing colon polyps early can help prevent cancer down the road.

Colorectal cancer screening guidelines

When to start screening for colorectal cancer

The American Cancer Society (ACS) recommends that all adults at average risk start colorectal cancer screening at age 45.

If any of the cancer risk factors listed above apply to you, earlier and more frequent colorectal cancer screening may be recommended. It is imperative to take interest in your family history. Do any members of your family have colon cancer or colon polyps? Any genetic syndromes? These two factors will likely increase the interval at which colonoscopy is recommended. 

If you are at an increased risk for colorectal cancer, talk to your doctor about when to begin screening, which test is right for you and how often to get screened to lower your risk.

Types of colorectal cancer screenings

It is important to note that prevention and detection are two different goals, and there are different tests to accomplish each. The ideal goal for screening is prevention — and for that, a colonoscopy is the gold standard. 

During a colonoscopy, the doctor uses a longer tube to check for polyps or cancer inside the rectum and the entire colon. The doctor is also able to find and remove most polyps and some cancers during this test. 

There are also various screenings methods to detect, not prevent, colon and rectal cancer. Stool-based tests check the stool for signs of cancer. They are typically less invasive than a colonoscopy but need to be done more often:

  • Highly sensitive fecal immunochemical test (FIT) every year
  • Highly sensitive guaiac-based fecal occult blood test (gFOBT) every year
  • Multi-targeted stool DNA test (mt-sDNA) every 3 years

Visual (structural) exams of the colon and rectum use a scope or special imaging (x-ray) to check the structure of the colon and rectum for any abnormalities:

  • Colonoscopy every 10 years
  • Flexible sigmoidoscopy (FSIG) every 5 years. During this test, your doctor puts a short, thin, flexible, lighted tube into your rectum, allowing them to check for polyps or cancer inside the rectum and lower third of the colon.

The ACS provides more detailed guidelines on colorectal cancer screening options here.

Talk to your doctor about the options available for colorectal cancer, and what they recommend for your health needs. Regardless of your chosen method, make sure regular screening for colorectal cancer is a priority. Frequency of colorectal cancer screening will vary based on which type you choose, your medical conditions and family history. 

Lastly, look out for your friends and family members — share your positive colon cancer screening experience and encourage them to get screened too. You just might save their life.

Ready to schedule your screening? Talk to your doctor or find a gastroenterologist near you today.

About the Author

Melvin Simien, MD, is a gastroenterologist and internal medicine physician on the medical staff at Baylor Scott & White All Saints Medical Center – Fort Worth.

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