Colon cancer (colorectal cancer) is the third most common cancer in the U.S. and the second leading cause of cancer-related death. Each year, more than 154,000 people in the U.S. are diagnosed with colon or rectal cancer.
Since the mid-’80s, the rate of colorectal cancer in older adults has steadily declined. This improvement is largely due to increased screening and changes in lifestyle-related risk factors. However, rates of colorectal cancer are rising among people younger than 50, which makes awareness and screening even more important.
The primary goal of screening is to prevent deaths from colorectal cancer. Screening tests can detect cancer at an early and potentially curable stage. Even more importantly, screening can help prevent cancer from developing in the first place by identifying precancerous growths called polyps. These abnormal growths can often be removed before they turn into cancer.
Most people should begin screening for colorectal cancer at age 45.
Some individuals may have a higher risk of developing colon cancer due to factors such as a strong family history of colorectal cancer or certain medical conditions. People at higher risk may need to begin screening earlier than 45 and may require different screening strategies. Discussing your personal risk factors with your health care provider can help determine the best screening plan for you.
There are different screening options available for colorectal cancer.
Colonoscopy is the most comprehensive screening test. During a colonoscopy, a doctor uses a thin, flexible tube with a small camera to examine the entire colon. This test is unique because it allows doctors to detect and remove polyps during the same procedure, making it both a diagnostic and therapeutic tool.
A colonoscopy can identify most small polyps and nearly all large polyps and cancers. If polyps are found, they can usually be removed immediately. If the colonoscopy is normal and you have no additional risk factors, the test typically does not need to be repeated for 10 years.
Another screening option includes stool-based tests, which check for hidden blood or abnormal cancer DNA in a stool sample. Some polyps and cancers can bleed, and these tests are designed to detect those signals. However, stool tests may miss 50-70% of advanced polyps, which are polyps that carry a higher risk of becoming cancer.
If a stool test result is positive, a colonoscopy is required as the next step to determine the cause.
Colon cancer screening saves lives. Detecting cancer early greatly improves the chances of successful treatment, and removing precancerous polyps can prevent cancer from developing altogether.
Every conversation about screening is an opportunity to prevent cancer. March is Colorectal Cancer Awareness Month, an important reminder to prioritize colon cancer screening and prevention.
Dr. Rinad Tabbalat is a board-certified gastroenterologist at Northwest Gastroenterology and Endoscopy in Bellingham. Her experience caring for patients with colorectal cancer across different age groups has inspired her dedication to advancing early screening and prevention.
