December 16, 2020
When Should You Start Colon & Rectal Cancer Screening?
The American Cancer Society (ACS) has created a new recommendation for colon & rectal cancer screening.
You may have heard that the time to start cancer screening of the colon and rectum is age 50. That was true previously, but the ACS has changed its recommendation to start screenings 45. This important change, as a result of research, can help you and your loved ones be more proactive about your health and catching colorectal cancer as early as possible.
What Is Colorectal Cancer?
Colorectal cancer refers to cancer that can involve the colon, the rectum, or both. This type of cancer involves polyps, which are small groups of cells that develop on the colon or rectum lining. Some polyps are not cancerous, some are pre-cancerous and can turn into cancer, or some already have early-stage cancer.
Why Is Colon & Rectal Cancer Screening Important?
Screenings provide a way to be proactive about your health and catching anything that is cancerous or even pre-cancerous before it grows into something more dangerous. Some colorectal cancer screenings can be done at home and other tests are able to identify the presence of any polyps. In some cases, polyps are removed, especially if the doctor feels they may be cancerous. Your doctor will recommend the one they feel is right for you.
Overall, early detection has the potential to catch cancer early and save your life. If you’re at least 45 with an average risk of colorectal cancer, it’s the right time to ask your doctor about screening. You’re also encouraged to get screening if you’re younger than 45 but have a high risk of this type of cancer.
How Do You Know If You Have Average or High Risk of Developing Colorectal Cancer?
While there is a new general screening recommendation, it can actually vary depending on your personal amount of risk. Your doctor may change your individual recommendation based on whether you have average or high risk of developing colorectal cancer. Let’s take a look at the difference:
- Average Risk: You may have average risk if you are generally healthy and do not have a family history of colorectal cancer, as far as you know. With this amount of risk, you would follow the screening recommendation of starting screening at age 45. Then, you would continue to receive screenings until age 75, when you would discuss with your doctor whether it’s worth continuing with screenings.
- High Risk: You may have a high risk if you have certain contributing factors. These include a family history of colon or rectal cancer, radiation of the pelvic region, or a history of inflammatory bowel disease. In this high-risk group, the recommendation is for you to start screenings before you reach age 45 and have more frequent screenings than the average-risk group. Your doctor could give you specific recommendations based on your individual health picture.
Why Did the ACS Change the Colorectal Screening Recommendation?
The recommendation to lower the screening age was made based on a full review of research that found a pattern of increasing rates of colorectal cancer among younger adults. The Guideline Development Committee of the ACS set the new screening age recommendation in an effort to create better early detection and work toward preventing new cancer cases.
Cancer research is continuing as researchers aim to find out why this pattern of increasing cases among younger adults has emerged. Current knowledge already tells us that lifestyle factors contribute to the cases. These factors include poor nutrition, a lack of exercise, and obesity.
People commonly think of colorectal cancer as a type associated with older people. But the ACS and researchers are striving to change that idea. This is because they estimate that rates of this cancer will increase by 90 percent in the age group of 20 to 34 and by 28 percent in the age group of 35 to 49 over the next 10 years. The ACS hopes that by creating more awareness about the new recommendation, they can help younger adults be proactive and get colon and rectal cancer screening.
Common Types of Colon & Rectal Cancer Screening
There are several screening tests for colorectal cancers. They generally fall into two different categories: Stool tests and visual tests.
Stool tests for colorectal cancer screening
For most people of average risk this is the first type of colorectal cancer screening test that’s done. These tests are done at home as prescribed by your doctor. The results will be sent to your doctor’s office for review with you.
- Fecal Immunochemical Test (FIT). This test looks for hidden blood in the stool by reacting to the part of the human hemoglobin protein, which is found in red blood cells. It’s recommended once a year.
- High sensitivity guaiac-based fecal occult blood test (HSgFOBT). Also suggested once a year by the American Cancer Society, this is similar to the FIT, but with a different type of chemical reaction used to detect the presence of blood in the stool.
- Stool DNA test. This stool test done every three years checks stool for blood and abnormal DNA from polyps or cancer.
Visual Colorectal Screening Tests
Common colorectal cancer screening tests include:
- Virtual colonoscopy. This screening method, also called computed tomographic (CT) colonography, uses specialized x-ray equipment (a CT scanner) to provide a series of images of the colon and the rectum from outside the body. It should be done about every five years.
- Standard (or optical) colonoscopy. In this test recommended about every 10 years, the rectum and entire colon are examined using a colonoscope. While sedated, a flexible lighted tube with a lens for viewing and a tool for removing tissue is inserted in the rectum and colon to check for unusual looking polyps or other signs of cancer.
The best method of screening depends on factors such as your age and risk for developing colon and rectal cancer. While some testing can be done without your doctor requesting it, you should talk to your doctor about these. The labs used may not be of the same quality as the one your doctor would use.
Spread the Word About Colorectal Cancer Screening at Age 45
You can also help by spreading the word. An important part of using screenings to reduce colorectal cancer is to talk about it more as a society. By talking more, everyone can become more comfortable with the topic and feel like it’s normal to get screened at a younger age.
Schedule your regular physical and talk to your doctor about which screening tests you should have performed for colorectal cancer and other types of cancer-based on your age and risk factors. It can save your life.