Every year, more than 97,000 people are diagnosed with colon cancer across the country. This year, more than 50,000 people will die from the disease, according to the American Cancer Society. More than 30 percent of Americans over 50 still haven’t been screened for colon cancer.
And now experts want to start looking for this cancer at an earlier age. “Young people are getting into the prime of their lives and developing colon cancer, but because they are young, they’re writing the symptoms off as something else when they should be getting screened,” Dr. Cerulli says. In a younger person, blood in the stool, changes in bowel habits, progressive abdominal pain and unexplained weight loss may be attributed to irritable bowel syndrome. In women, iron deficiency anemia, another symptom of colon cancer, might be attributed to their menses.
Dr. Cerulli points out that colon cancer is unlike many other cancers in that screening can actually prevent the disease. “In breast, prostate or lung cancer, you’re looking for small, early-stage cancer tumors. In colon cancer, you’re screening for precancerous growths that you can treat before someone develops cancer.”
The gold standard for colon cancer screening is a colonoscopy—a scope (a flexible tube with a light and tiny TV chip at one end) is inserted through the anus and snaked through the rectum and colon. The doctor is looking for polyps—growths on the inner surface of the colon that are not cancerous, but can develop into cancer. If doctors find a polyp, they can remove it then and there with special instruments inserted through the same scope.
If you have a colonoscopy with no abnormal findings or polyps, then you don’t need another one for 10 years. But not everyone is comfortable enough with the idea of the scoping or the preparation to have one—as is evident in the low screening numbers among those 50 and older.
There are other options, Dr. Cerulli explains, but they come with their own risks and benefits.
The fecal immunochemical test, or FIT, looks for hidden blood in stool that may indicate the presence of a polyp. Your doctor can provide a kit for you to collect the stool sample. These tests can be done at home, but they must be done annually. If a test is positive, you’ll need to have a colonoscopy.
The Cologuard test detects DNA from cancer or polyps in a stool sample. Your doctor can request the test for you to use at home. It has detailed instructions for collecting and preparing the stool so the DNA can be tested. Even though it looks for DNA from polyps, it can still miss them or return false-positive tests. DNA testing should be repeated every three years.
Dr. Cerulli says that while a colonoscopy is invasive, it’s the best cancer-preventing test. FIT and Cologuard are not invasive like a colonoscopy, but they must be done more frequently and positive tests will require a colonoscopy anyway. They also have one drawback in common—“Not everyone wants to handle stool,” Dr. Cerulli says.