Don't ignore colorectal cancer screening

If you knew you could reduce your risk of dying from colorectal cancer by 60 percent, would you do it?

Most people would probably answer, “Yes of course.” However, while colorectal screening has been shown to be effective in reducing the risk of death, many remain hesitant to have such tests.

Their reasons for hesitating range from apprehension and embarrassment about colorectal cancer screening tests, such as colonoscopies, to natural reluctance about undergoing an invasive test when they feel healthy and show no symptoms of disease.

But if you are over age 50, regardless of how you feel or any other factors, it makes sense to be screened for colorectal cancer. In fact, it may save your life.   

Colorectal cancer is the general term for cancer that occurs either in the colon or the rectum, sometimes called “colon cancer.” It is the No. 2 killer among cancers in the United States. However, according to the Centers for Disease Control and Prevention (CDC), regular cancer screenings for persons over age 50 can reduce deaths by as much as 60 percent.

Statistics indicate that screenings work, as the rate of new cases and deaths from colorectal cancer has declined by almost 5 percent between 2002 and 2004. Still, more than 147,000 new cases are found each year, and over 57,000 people die from colorectal cancer each year, according to the National Cancer Institute.

The following are screening tests for colorectal cancer:

• Digital Rectal Exam
  
• Fecal Occult Blood Test (FOBT)
  
• Flexible Sigmoidoscopy
  
• Combination FOBT and Flexible Sigmoidoscopy
  
• Colonoscopy
  
• Double-Contrast Barium Enema
  
• Computed Tomography (CT) Colography

Does colorectal cancer screening really work?

Screening can find polyps before they become cancerous as well as cancers at an early stage. If a screening detects any abnormality, diagnosis and treatment can occur promptly. The National Cancer Institute says that finding and treating polyps may be the most effective way to prevent cancer. Moreover, cancer is generally more treatable when found early. 

You may be at risk for colorectal cancer even if you have no history of the disease in your family, or if you have no obvious symptoms, such as a change in bowel habits or blood in the stool. In fact, the CDC estimates that roughly 75 percent of colorectal cancers occur in people with no known risk factors. Colorectal cancer affects both men and women of all racial and ethnic groups. People over 50 are at the greatest risk for colon cancer, as well as people with:

• A family history of colorectal cancer or colorectal polyps
  
• A personal history of cancer of the colon, rectum, ovary, endometrium, or breast
  
• Certain diseases of the intestines, such as inflammatory bowel disease, ulcerative colitis, or Crohn’s disease
  
• Genetic syndromes

Many factors determine a person’s chances of recovery from colorectal cancer, and none is more important than the stage of the cancer. The earlier it is found, the greater the chance of full recovery.

There are things you can do that may reduce your risk of contracting colorectal cancer. The Centers for Disease Control and Prevention (CDC) recommends increasing your physical activity, eating fruits and vegetables, limiting alcohol consumption, and avoiding tobacco. Studies have shown that maintaining a healthy weight and increasing physical activity can decrease risk. If you are over 50, or have other risk factors for colorectal cancer, you should obtain a screening.

Digital Rectal Exam – This is an exam of the rectum done in a doctor’s office. A lubricated, gloved finger is inserted into the rectum to feel for lumps or anything else that seems unusual.

Fecal Occult Blood Test (FOBT) – This is a test for hidden blood in the stool. This can be done at home by placing a small amount of stool from three consecutive bowel movements on test cards and returning them to a doctor’s office or lab. This test is recommended annually.

Flexible Sigmoidoscopy – Prior to taking this test, a strong laxative or enema must be used to clean out the colon. This test is conducted in a doctor’s office, clinic, or hospital. The doctor inserts a narrow, flexible, lighted tube to look at the inside of the rectum and the lower portion of the colon. Polyps may be removed during the test and tissue samples collected for further examination. This test is recommended every five years.

Combination FOBT and Flexible Sigmoidoscopy – Some physicians believe taking both tests increases the chances of finding polyps and cancers.

Colonoscopy – Prior to taking this test, you need to take a strong laxative to clean out the colon. This test is usually conducted in a clinic or hospital. Many times, a sedative is given to make you more comfortable during the test. Most times the sedative will make you drowsy and unable to drive yourself home after the test. The test is similar to the flexible sigmoidoscopy, except that the tube used is longer and enables the physician to see the entire colon. The colonoscopy is often used as a follow-up when other tests determine a need for it. A colonoscopy is recommended every 10 years.

Double-Contrast Barium Enema – This test is conducted in a radiology center or hospital. Prior to the test, you need to use a strong laxative or enema to clean out the colon. During this procedure you are given an enema with a barium solution, followed by an injection of air. X-rays of the rectum and colon are taken. The barium coats the lining of the intestines so that polyps and other abnormalities are visible. The test is recommended every five years.

Computed Tomography (CT) Colography – Also known as a “virtual colonoscopy,” this new technique takes computer-generated x-ray images after air is injected into the colon.