Understanding Colorectal Cancer Screening

It develops when cells in the colon or rectum grow abnormally into polyps and go undetected long enough that they become cancerous. Because CRC can progress without symptoms, it is often undiagnosed until the cancer is too advanced to cure.  They key to survival is early detection through screening.

“It is imperative to get screened at the appropriate age based on your risk factors for CRC,” said Michael Yao, M.D., Chief of Gastroenterology and Hepatology at the Washington DC VA Medical Center. “Screening can detect polyps before they become cancerous and allows us to remove them. If caught early, death from CRC is preventable.”

The VA recently lowered the recommended age to begin CRC screening from 50 to 45 years old for Veterans with no risk-factors. Your primary care provider may suggest screening earlier if you have any of these risk factors:

• Family history of CRC or advanced polyps
• History of inflammatory bowel disease
• Certain familial genetic syndromes

Types of Colorectal Screening

Screening intervals vary depending on the type of test that you and your primary care provider choose. There are several ways to screen for polyps and early signs of CRC and the Washington DC VA Medical Center offers these methods:

FIT – A fecal immunochemical test uses antibodies to detect blood in the stool. Your primary care provider will give you a kit to collect a sample of your stool at home. The test is then returned to a lab where the sample is checked for blood. This form of screening is recommended annually.

Colonoscopy – During a colonoscopy, a doctor uses a thin, flexible, lighted tube to check for polyps or cancer inside the rectum and colon. Polyps found during this test can usually be removed at the same time as the exam. Colonoscopies are recommended every 10 years as long as no risk factors arise.  

All CRC screening methods are very effective at finding polyps, cancer or abnormalities in the colon or rectum, but a colonoscopy is the preferred test for Veterans who have increased risk factors. A colonoscopy will likely also be recommended as a follow-up test if any of the above screening methods reveal abnormalities. Speak with your primary care provider about which test is best for your health.

Yao stressed that screening for CRC should not be an embarrassing topic to discuss with others and encouraged Veterans to ask questions to feel more comfortable with the subject.

“A lot of the fear over screening is based on false preconceptions and stigma but the bottom line is this: screening saves lives, and the benefits outweigh any momentary discomfort,” said Yao. “Ask family and friends for their experiences, discuss your concerns with your primary care physician to make sure you understand what to expect, and schedule your screening when recommended. It could save your life.”

To schedule an appointment with your primary care provider to discuss colorectal cancer screening, visit: Make An Appointment | VA Washington DC Health Care | Veterans Affairs