Colorectal cancer screenings are an important step toward early diagnosis, but many people avoid colonoscopies because of fear of discomfort. With the increase in incidence of colorectal cancer in younger age groups, Sarah Cannon and other organizations including the American Cancer Society are recommending screening start as early as 45 years old. Sarah Cannon recommends a flexible sigmoidoscopy every five years or a colonoscopy every 10 years for both men and women with average risk. Adults age 76-85 should discuss the decision to screen with their physician. People with known risk factors should talk to their doctor about earlier or additional screenings. According to figures from the Centers for Disease Control and Prevention (CDC), one quarter of adults 50-75 years old have never been screened.
Making screenings more patient-friendly
Though colonoscopies are the gold standard for colorectal cancer screening, there are a number of patient-friendly screening options that have become available for colon cancers.
There is a fecal-based, non-invasive DNA screening test for colorectal cancer available. This test couples sensitivity toward patient preference for less invasive options with the demand for more reliable screening methods. This multi-target stool DNA test combines testing the stool for molecular markers associated with colorectal cancers with a Fecal Immunochemical Test (FIT test) to look for blood in the stool that can be associated with colorectal polyps and cancers. This screening option is more sensitive for colorectal cancer detection than a FIT kit alone and can be performed every three years if the results are negative.
A FIT kit is an at-home test that screens for occult or hidden blood in the stool that could be a sign of precancerous polyps or colon cancer. A trained nurse navigator specialized in gastrointestinal (GI) cancers will follow up with participants of FIT kits regarding their results and serve as a guide to schedule additional testing and coordinate insurance needs if testing is positive. FIT kits should be performed yearly.
“Ideally, we would like everyone over the age of 45 to receive a colonoscopy and those with a family history of colon cancer to begin screenings even earlier,” says Meredith Pelster, MD, MSCI, Investigator, Sarah Cannon Research Institute at Tennessee Oncology. “Stool-based testing options can make it easier for some patients to screen for colon cancer and remove barriers associated with colonoscopies. If stool-based testing is positive, however, a colonoscopy should be performed.”
These are just two of a number of options available for patients. Other screening options include CT colonography (“virtual colonoscopy”) and fecal occult blood tests (FOBT).
While some of these new screenings may be less effective than more invasive procedures and may lead to false positives, Dr. Pelster pointed out that these alternative methods are better than no screening at all, especially for patients who would otherwise forgo screening.
“We want to take whatever steps we can do to diagnose colon cancer at an early stage,” she says. “Stool-based tests along with colonoscopy and other options can help us achieve early diagnosis for more patients.”
It is important to know that the information in this post, including Sarah Cannon’s recommendations for screening, is accurate as of the publishing date.