March is Colorectal Cancer Awareness Month

You can lower your chances of the disease by living a healthy lifestyle and undergoing screening.  Screening now begins at age of 45 and generally continues to age 75.

In 2022, an estimated 151,030 cases of colorectal cancer (CRC) were diagnosed in the U.S., and a total of 52,580 people died from the disease.

Screening for CRC aims to detect early cancer when it is easier to treat or to detect precancerous growth (polyps) that have potential to become cancerous.  The polyps can be removed before they become cancerous.  CRC screening is done on people who have no symptoms and feel fine.  The goal of screening is to find polyp lesions before they become cancerous and remove them.  Many studies show that regular colorectal cancer screening lowers the chances of developing the cancer or dying from CRC.

There are several screening test options including noninvasive methods such as fecal immunochemical test (FIT) as an alternative to more invasive colonoscopy.  The FIT test detects small amounts of blood is stool that is not visible by naked eye and would not be noticed.  Colonoscopy and FIT are used most often but there are other tests that can be used to screen for CRC, ask your doctor for more details.  Currently there is no blood test that can be recommended.

Stool tests for blood such as FIT test detect small amounts of blood.  You collect a small amount of stool and place it in a container you get in your doctor’s office or a laboratory and ship it for analysis.  Cancerous and precancerous polyps can bleed, and the blood is detected by these tests.  Other lesions such as hemorrhoids can bleed as well but positive test is usually followed by colonoscopy as soon as possible.  The advantage of stool tests is that they are noninvasive, and you do not have to cleanse your colon. The disadvantage is that they do not detect polyps as well as colonoscopy and that they can turn positive for reasons other than presence of a cancer or precancerous lesion.

Colonoscopy allows your doctor to visualize directly the entire inside of your colon and remove polyps and analyze it for cancerous growth.  You must cleanse your colon by drinking a laxative before the procedure.  The doctor places a flexible tube with camera in your anus and advances it to the end of your colon.  The advantage of this test is it can detect and remove most precancerous polyps.  It is sometimes possible to remove large lesions or cancerous polyps without a need for surgery.  If your colonoscopy is normal usually you do not need another one for 10 years.  If polyps are removed, you may need a follow up colonoscopy in few years.  Disadvantage of colonoscopy is that it requires a thorough colon cleansing and has some risks such as bleeding or tearing the colon lining.  However, the complications are rare.  If you choose to have anesthesia for the procedure you cannot drive or work for a day after the test.

You should see your doctor immediately if you notice symptoms such as blood in stool, have recent changes in bowel habits, become anemic, have unintentional weigh loss or some abnormality on radiological imaging. Seeking help when you have symptoms is not a screening but a diagnostic workup.

For more information, contact your care team or visit Colorectal (Colon) Cancer | CDC