Colorectal cancer is preventable. Screening is the best way to improve chances of survival through early detection.
It is very important you know your risk.
Who is considered an average-risk patient?
Average-risk patients can use any of the recommended colorectal tests. You are at average risk if you do not have:
– A personal history of colorectal cancer or certain types of polyps
– A family history of colorectal cancer or polyps
– A personal history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease)
– A confirmed or suspected hereditary colorectal cancer syndrome, such as familial adenomatous polyposis (FAP) or Lynch syndrome (hereditary non-polyposis colon cancer or HNPCC)
– A personal history of getting radiation to the abdomen (belly) or pelvic area to treat a prior cancer
Who is considered a high-risk patient?
High-risk patients are strongly advised to use colonoscopy for their screening. People at increased or high risk of colorectal cancer might need to start colorectal cancer screening before age 45, be screened more often, and/or get specific tests. This includes people who do have:
– A strong family history of colorectal cancer or certain types of polyps
– A personal history of colorectal cancer or certain types of polyps
– A personal history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease)
– A known family history of a hereditary colorectal cancer syndrome, such as familial adenomatous polyposis (FAP) or Lynch syndrome (also known as hereditary non-polyposis colon cancer or HNPCC)
– A personal history of radiation to the abdomen (belly) or pelvic area to treat a prior cancer
What are the tools available for colorectal cancer screening?
Stool-based tests:
– FIT/FOAG stool Test every year if negative.
– DNA/FIT stool test – Cologuard every three years if negative
Endoscopy-based tests:
– Flexible sigmoidoscopy every five years if negative
– Colonoscopy every 10 years if negative
Radiology-based tests:
– Virtual (CT) colonography every five years
– Barium Enema every five years
Capsule colonoscopy is only for patients with incomplete colonoscopy. Other FDA approved tests (like blood tests) for screening exists, but not been recommended by American cancer society and other major Societies in the US. High quality colonoscopy is recognized as the gold standard. However, getting any of the above tests is better than no test at all. Remember our goal is getting 80 percent of our community to start screening by age 45.
Why is colonoscopy preferred over the other tests?
I am biased toward high quality colonoscopy because it is the only test that fully evaluates the colon and rectum, does better with detecting smaller polyps and removing polyps and even some very early colon cancers.
I don’t want any polyp growing to be of any size or becoming cancer before detecting it.
Remember, colorectal cancer is preventable and can be detected early enough to save your life. Don’t wait to develop colorectal cancer.
Gastroenterologist Dr. Kwadwo Agyei-Gyamfi is affiliated in private practice with Acme Medical Specialties in Lumberton and is a member of the UNC Health Southeastern Medical Staff.
