Health Matters: Understanding Your Colorectal Cancer and Screening Options

Understanding Your Colorectal Cancer and Screening Options
By Dr. Alok Jain

Colorectal cancer is the fourth most common cancer, but the second leading cause of cancer-related deaths in men and women. Screening for colorectal cancer could help save your life, but it is possible that you may be confused on what option is best.

Screening tools are important prevention and early detection offerings that can find precancerous polyps — abnormal growths in the colon or rectum — that can be removed before they turn into cancer. Screenings can also detect cancer early, which is best for treatment options.
Recent data shows that colon cancer is impacting patients at younger ages than seen before, which is why anyone at average risk for colon cancer should begin regular screenings at forty-five years old. It is also important for those who have a family history of colorectal cancer or colon polyps to have regular screenings. Individuals may also be at higher for colon cancer if they have an inflammatory bowel disease or if they have certain genetic syndromes.

Chances are you’ve seen television ads for at-home colon cancer screening kits or maybe you’ve been putting off scheduling your regular colonoscopy. With so many changing technologies and at-home options, it can be overwhelming to know and understand which screening option is best for you.

Colonoscopies

are the gold standard when it comes to screening for colorectal cancer. This procedure uses a long tube to check for polyps or cancer inside the rectum and the entire colon. Patients should have a regular colonoscopy every ten years starting at age forty-five, unless your doctor says that it should be done sooner, based on your medical history. Colonoscopies are also used as follow up tests if anything unusual is found during other types of screenings.

What about at-home screening options? There are various kits you can use in the comfort of your own home to screen for colorectal cancer. High-sensitivity fecal occult blood testing (FOBT) and stool DNA tests check for blood or cancer cells in your stool using various testing techniques. If you’ve seen ads for Cologuard while watching your favorite TV show, this is one such screening kit that examines stool DNA to detect DNA and blood cells in the sample you provide. If you were to choose one of these screenings, they are recommended every three years following a negative result.

Additional screening options include flexible sigmoidoscopies (flex sig), double contrast barium enemas and virtual colonoscopies. Flex sig screenings, which lack sensitivity and specificity in comparison to colonoscopies, use a short, thin, flexible, lighted tube to check for polyps or cancer in the rectum and lower third of the colon, whereas patients who opt for a double contrast barium enema receive both a liquid and air enema, so the doctor can see the outline of their colon on an x-ray. Virtual colonoscopies also use x-rays and computers to produce images of the entire colon. You will not receive these if a colonoscopy or Cologuard is available to you.

If it’s time for your regular screening and you’re unsure about which option might be best for you, it’s important that you talk to your doctor. Together, you can discuss each of these screenings and which would be optimal based on your medical history.

Insurance

As is the case with any procedure, insurance plans may or may not cover various screening options, based on the coverage they offer. Before setting up your screening, be sure to check your plan to know what is covered.

It is also important that you can recognize the symptoms of colorectal cancer if you’re in between screenings or not yet forty-five years old. People who have polyps or colon cancer may not have symptoms at first and someone could have it and not even know it – which is why screenings are so important.

Symptoms

Those who do experience symptoms sometimes have blood in or on their stool after a bowel movement, stomach aches, pains or cramps that won’t go away, or unexplained weight loss. If you have any of these symptoms, it’s important that you talk to your doctor right away. Of course, these symptoms could be caused by something other than cancer, but seeing your doctor is the only way to find out what might be causing them.

No matter what option you choose for your next screening, what matters most is that you’re getting it done. Screenings save lives.
*Alok Jain, MD, is a gastroenterologist with Mercy Health – Lorain Gastroenterology. Dr. Jain graduated from Bangalore Medical College Rajiv Gandhi University of Health Sciences and completed his residency and fellowship at MetroHealth Medical Center. He completed his advanced endoscopy fellowship at Geisinger Medical Center in Pennsylvania. He is board certified in AB Internal Medicine-Gastroenterology.