Colorectal Cancer: Screenings, Early Detection and Prevention

According to the American Cancer Society, around 1 in 23 men and 1 in 25 women will develop colorectal cancer in their lifetime. While colorectal cancer is common, it often can be prevented. By getting screened, you can find colorectal cancer early when it is most treatable.

When should you start colorectal cancer screenings? What kind of screening might be right for you? Get answers to these questions and more in this guide. 

What is colorectal cancer?

Colorectal cancer collectively refers to cancer of the colon and rectum:

• Colon cancer: Affects the large intestine above the rectum.
• Rectal cancer: Occurs when the cancerous tumor is located in the rectum.

Most types of colorectal cancer begin as small tumors that grow in the colon or rectum. These tumors are called polyps. While not all polyps are precancerous, over time, some polyps can continue to grow and develop into colorectal cancer. 

Why should you get checked for colorectal cancer?

There are many reasons why colorectal cancer screenings are important. 

• Colorectal cancer often has no symptoms. Cancer can be in your body even if you feel good. Screenings can find the cancer early, when it is easier to treat.
• Colorectal screenings prevent cancer and save lives. Screenings can help find small growths, called polyps, that can be removed before they turn into cancer.
• A family member has had colorectal cancer. You are more likely to get colorectal cancer if a family member has had it. Ask your family about their health history and talk to your provider about your risk. 
• You are Black American. Black Americans have the second-highest mortality and incidence rates of colorectal cancer in the U.S. They are 35% more likely to die from colorectal cancer and 15% more likely to develop it than non-Hispanic whites.
• You are Alaska Native. Alaska Native people are twice as likely to get colorectal cancer compared to Alaska Whites.
• You are 40 years or older. Over 90% of men and women who get colorectal cancer are over the age of 50.

Colorectal cancer screenings can save lives. 

The American Cancer Society reports that colorectal cancer found in the early “localized” stage has a 91% survival rate. That’s why screenings are so important! Screenings help you find colorectal cancer early when treatment is easiest and most successful.

Some types of screenings can even help you prevent colorectal cancer altogether. For example: During a colonoscopy, if a healthcare provider finds a pre-cancerous polyp, they can remove that polyp immediately before it turns into cancer.

What are the different kinds of colorectal cancer screenings? 

There are several options for colorectal cancer screening. Your health care provider will help you decide which screening is right for you. Here’s what you should know about the most common types of screenings.

Stool-based tests

This type of screening uses a stool sample to check for signs of polyp growth or colorectal cancer. Stool-based tests can be done at home, are available at a lower cost and don't require bowel prep or sedation. However, stool-based tests need to be done more often than visual tests. They can also miss many polyps and some cancers, and they may require a follow-up colonoscopy if your test results are abnormal.

There are three kinds of stool-based tests:

• Guaiac-based fecal occult blood test (gFOBT) - every year
• Fecal immunochemical test (FIT) - every year
• Multi-targeted stool DNA test (MT-sDNA) - every 3 years

Your healthcare provider will help you decide which type of stool screening is right for you. 

Visual-exam tests

Visual-exam tests are done in a doctor's office or health facility, and they all require bowel prep. Types of visual-exam tests include:

• Colonoscopy - every 10 years
• CT colonography (virtual colonoscopy) - every 5 years
• Flexible sigmoidoscopy - every 5 years

Only a colonoscopy can remove and test polyps. If you have an abnormal result from any other test, a colonoscopy is required. Your health care provider will help you determine which type of test is right for you. 

When should you get screened for colorectal cancer?

Adults with an average level of risk should start colorectal cancer screenings at age 45.

If you’re at high risk of colorectal cancer based on family history or other factors, you may need to start screening before age 45, be screened more often, or get specific tests. For example: Alaska Natives should begin screenings at age 40. If you have questions about when you should begin screenings, talk to your primary care provider.

How do I reduce my risk for colorectal cancer? 

In addition to getting regular screenings, you can reduce your risk by:

• Eating a healthy diet. Limit red and processed meats, and add fruits, vegetables, and whole grains to your diet.
• Getting more exercise. Aim for at least 150 minutes of moderate exercise each week.
• Working towards a healthy weight. The best way to reach and maintain a healthy weight is by eating a healthy diet and exercising regularly.
• Quitting smoking. Smoking increases your risk for many types of cancer, including colorectal cancer. Call the CDC’s 1-800-QUIT-NOW hotline to learn about nationwide resources that can help you quit. You can also join a free Cone Health Smoking Cessation class.
• Reducing alcohol intake. Avoiding alcohol altogether can help you reduce your risk for colorectal cancer. If you do drink, drink in moderation.
• Keeping up-to-date with physicals and taking any prescribed medication. Your health care provider can help you determine the right screenings for you, and will help you maintain or improve your overall health. 

Talk to your doctor about colorectal cancer screenings. 

Screenings save lives. Don’t wait – talk to your health care provider about when you should start screenings. Schedule today with a Cone Health gastroenterologist to help detect, diagnose and prevent cancer. Cone Health also offers free FIT tests for patients who are uninsured or underinsured. Call (336) 832-0849 for more information or to get a test.