Colon Cancer Screening
What You Need to Know About the New Colon Cancer Screening Recommendations
You may have seen in the news recently that the age in which colon cancer screening is recommended has changed.
The American Cancer Society has updated its guidelines now recommending that screening begin at age 45. For years it has been advised to begin screening at age 50.
But before you go start drinking your GoLYTELY, we would like to give you a broader perspective of the recommendations and important considerations.
Is It Worth It?
Colon cancer screening is one of the most successful screening programs that we have available to us. Not only can we detect colon cancer but we can effectively intervene and remove the cancer through early detection.
Colon cancer is the fourth most common cancer diagnosis in the United States and is the second leading cause of death from cancer.
Therefore, we wholeheartedly advocate that every one of our patients get screened at the appropriate time.
Why Did the Recommendation Change?
The American Cancer Society recognized that there has been an overall decline in death from colon cancer; largely attributed to changes in exposure to risk factors as well as to increased screening. However, it was also recognized that there was an over 50% increase in cancer in those younger than age 55. This led the group to change their recommendation for screening to begin at an earlier age for average risk patients.
However, to make things confusing, not all groups endorse this change! The United States Preventative Task Force and The American Academy of Family Physicians maintain their recommendation to begin screening at age 50.
These groups plan to review the evidence for the new guideline, however, it is not expected that they will change their recommendation. The reason is that although there has been an increase in colon cancer in younger patients, research has not yet been performed to demonstrate a clinical benefit with no additional harms with earlier screening.
It is also important to note that those with a hereditary colon cancer condition, a family history of colon cancer, or a specific medical condition that increases your risk may need earlier screening.
What Test Should You Get?
Making the decision to screen for colon cancer and at what age is one consideration, but you also need to decide what screening method is right for you.
There are basically three main screening options which include: colonoscopy, flexible sigmoidoscopy (with or without combined stool testing), and stool testing alone.
Colon Cancer Screening Options
Frequency | Considerations | |
Colonoscopy | Every 10 years | Removal of polyps/lesions can be performed during screening exam.
Requires anesthesia. Has risk of harm, although rare. May not be covered by insurance. |
Sigmoidoscopy | Every 5 years | Removal of polyps can be performed during screening exam. Requires less prep than a colonoscopy and often does not require anesthesia/sedation.
Only allows for visualization of left side of colon. Note: right-sided colon cancers are found more often in women. |
Sigmoidoscopy + Stool Testing | Every 10 years | See above with the addition that stool testing increases chance of detecting right-sided colon cancers. |
Stool Testing (gFOBT, FIT) |
Every year | Does not require bowel prep. No anesthesia required. Can be performed at home.
Detection lower than with colonoscopy. Will need to have colonoscopy for a positive test. |
Stool DNA Testing (Cologuard) | Every 3 years | Does not require bowel prep. No anesthesia required. Can be performed at home.
FDA approved age 50 to 85. Detection rates on par with colonoscopy. Will need to have colonoscopy for a positive test. |
Let’s Talk…
What it comes down to is this: every patient is unique. You have a unique medical history and a unique perspective. We understand that individualizing your medical care and shared decision making is essential to our role as your healthcare provider. So, let’s talk about when and what screening test is right for you.
Prevention!
Finally, although we advocate for colon cancer screening, we advocate even more strongly for PREVENTION! The lifestyle factors that have been shown to prevent colon cancer overlap with those that we know to prevent other chronic diseases such as heart disease and diabetes. And, we know that establishing a healthy lifestyle contributes to overall health, wellness and happiness. The lifestyle factors that prevent colon cancer include:
- Eat an abundance of fresh fruits and vegetables every day
- Ensure a high fiber diet
- Get an adequate amount of calcium in your diet
- Avoid intake of red and processed meats
- Maintain a healthy weight
- Exercise regularly
- Don’t drink alcohol or drink a modest amount
- Don’t smoke
If you have any questions about colon cancer, screening, and what might make sense the most for you, don’t hesitate sending us a note or scheduling an appointment with your provider.