Who should be screened for colon cancer?
Evidence shows a clear benefit and reduction in mortality why people from the ages 50-75 are periodically screened for colon cancer. This may come as very clear to some people, though as of 2016 one third of eligible people in the USA have never been screened. People with a family history of colon cancer should be screened from the age of 40, and African Americans who are at higher risk for being diagnosed with colon cancer should be screened from age 45. After the age 75, recommendations vary depending on the individual. Healthy adults who have never been tested may benefit, though this depends heavily on the current health, and the individuals ability to undergo operation and other treatments for colon cancer.
What does it mean to be screened for colon cancer?
There are a number of techniques used to screen for colon cancer. There are fecal tests which can either use lab techniques to look for cells, and there are also techniques looking for occult blood. Other fecal exams examine the DNA to see if there are mutations in the gene expression.
Another form of screening is a visual test, using a camera to search the colon for abnormal bumps, growths or polyps. This is called a colonoscopy. There are also sigmoidoscopes which only look at the last part of the colon (beside the rectum), which is a common place for colon cancer.
Lastly, there are blood tests that can be used to screened for colon cancer.
So, what do I do?
The exact recommendations vary from place to place, from organization to organization. Canadian recommendations for example released in 2016 strongly recommended that individuals from age 60-75 be screened for colorectal cancer with fecal exams every 2 years or flexible sigmoidoscopy every 10 years. This was also recommended for people ages 50-60, but the evidence to support the benefits were a little weaker. In 2015 the American College of Physicians put out 4 possible strategies which you can see here. The main issue here, is individuals from the age of 50 (or earlier if you have family history or are African American) should be in touch with their physician to properly create a plan that is appropriate for them, taking into consideration the available resources, flexibility of the schedule, risk factors and other such things.
Does it work?
The evidence that shows the benefit of screening for colon cancer is extremely convincing. Annual fecal testing along reduced mortality rates up to 32%. Sigmoidoscopy exams also showed a reduction of 27% in mortality in 11-12 year follow ups.
Although there is no current completed trial that accurately describes the benefits of screening with colonoscopy, it nevertheless is recommended for a number of reasons, one of them being the promising results of currently ongoing trials.
Early treatment is absolutely critical when dealing with colon cancer as well. The 5 year survival rate of people diagnosed with stage 1 colon cancer is over 80%, though stage 4 colon cancer has less than a 20% 5 year survival rate. Enough said, this is a disease that is extremely beneficial to diagnose as early as possible.
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Knowledge is power. It’s very important for each of us to understand what our options are, and what evidence supports each option. Preventing diseases before they start is often the most efficient way to be healthy, and this starts by screening for the diseases that are appropriate for us depending on age, gender, and other factors. Download our app to go through a short list of questions, and receive a personalized list of the appropriate screening recommendations for you. More information about each of these tests is provided through the app, so that you can stay informed and educated.
Here are a few studies which prove the efficacy of screening and early treatment for colon cancer. Feel free to contact us for more information about the matter, we would be happy to provide it for you.
Lin JS, Piper M, Perdue LA, et al. Screening for Colorectal Cancer: A Systematic Review for the U.S. Preventive Services Task Force. Evidence Synthesis No. 135. AHRQ Publication No. 14-05203-EF-1. Rockville, MD: Agency for Healthcare Research and Quality; 2016.
Zauber A, Knudsen A, Rutter CM, Lansdorp-Vogelaar I, Kuntz KM. Evaluating the Benefits and Harms of Colorectal Cancer Screening Strategies: A Collaborative Modeling Approach. AHRQ Publication No. 14-05203-EF-2. Rockville, MD: Agency for Healthcare Research and Quality; 2015.
Shapiro JA, Klabunde CN, Thompson TD, Nadel MR, Seeff LC, White A. Patterns of colorectal cancer test use, including CT colonography, in the 2010 National Health Interview Survey. Cancer Epidemiol Biomarkers Prev. 2012;21(6):895-904.
Dignam JJ, Colangelo L, Tian W, Jones J, Smith R, Wickerham DL, et al. Outcomes among African-Americans and Caucasians in colon cancer adjuvant therapy trials: findings from the National Surgical Adjuvant Breast and Bowel Project. J Natl Cancer Inst. 1999;91(22):1933-40.