Tag Archive for: colonoscopy

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Blood-Based Testing Could Improve Colorectal Cancer Screening Rates

Regular screening, surveillance, and high-quality therapy can help prevent colorectal cancer (CRC) incidence and mortality. However, a lot of people put off being tested for a variety of reasons, including:

  • Hearing from others that the test could be challenging or uncomfortable and that talking to their doctor about CRC or handling feces could be embarrassing
  • In the absence of a family history of CRC, they believe they are not at risk and don’t need to be screened
  • Cost of getting tested
  • The complexity associated with screening, which could include out-of-pocket costs, taking time off work, and transportation to the clinic 

Here’s information on the different types of screening options for CRC.

Blood Tests Are Emerging as a Potential Screening Option

While legitimate, these concerns have over time created obstacles to CRC detection at an early stage, when the cancer is easier to treat. But, alternative options are being developed that do not require handling stool samples or undergoing a colonoscopy (which may need time off from work), such as blood-based testing. 

A study that was recently presented at the annual meeting of the American College of Gastroenterology, found that patients who were given the option to undergo a blood-based CRC screening test were more than twice as likely to finish the screening process than those who were given the stool-based option.

Of the 1,927 eligible study participants, 924 were assigned to the blood draw group and 1,003 to the stool-based testing group. More than 50% of participants in the blood-draw group made an appointment with the research team after they were contacted by phone. After three months, CRC screening was 19.4% higher in the blood-test group than the stool test group (32.4% vs. 13.0%). 

Traditional CRC Screening Options

Traditionally, the following screening options have been use for those with an average risk of CRC (meaning no family history of polyps of CRC or personal history of polyps or CRC):

  • Fecal immunochemical test (FIT) test is performed annually
  • FIT-DNA test is performed every three years
  • Guaiac-based fecal occult blood test (gFOBT) is performed annually to screen for CRC
  • Colonoscopy is performed once in ten years

The FIT and gFOBT tests are at home and require a small bit of stool sample to be collected with a stick or brush and sent to a laboratory for testing. On the other hand, a whole bowel movement is taken for the FIT-DNA test and sent to the lab to be examined for altered DNA and the presence of blood. 

A colonoscopy is a little more complicated in that it requires some preparation the previous day and anesthesia during the procedure.  

On the contrary, extracting blood may be less painful, awkward, or time-consuming. Blood-based tests for CRC can have several benefits and lower testing barriers. Nevertheless, patients need to be properly informed of their options, and more research is required to gauge the extent to which blood tests for CRC are effective and comparable to other screening options in detecting cancer.

 

Emmanuel Olaniyan is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation.

 

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NEHI Report Proposes Solutions for CRC Screening Disparities

The Network for Excellence in Health Innovation (NEHI) conducted research to shine a spotlight on disparities in colorectal cancer (CRC) screening and has proposed short-term and long-term recommendations to address these disparities. The report, Addressing Persistent Disparities in Colorectal Cancer Screening Among Racially and Ethnically Diverse Populations, proposes solutions that would help close existing gaps and legislative involvement for long-term resolutions.

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Colonoscopy Reminders Increase Screening Rates Among High-Risk Individuals

By Deepthi Nishi Velamuri


Colorectal cancer (CRC) is a significant health concern, particularly for those with a family history of the disease. Unfortunately, many existing screening programs overlook this high-risk group. However, a recent study conducted at the University of California Los Angeles (UCLA) has introduced an innovative intervention aimed at improving CRC screening rates in individuals with a family history of CRC. 

The study was presented at Digestive Disease Week 2023.

A Game-Changing Intervention

The researchers at UCLA conducted a study within their large academic health center that already had a screening program for average-risk individuals. They aimed to engage individuals with a family history of CRC who were resistant to screening and determine the effectiveness of the intervention in increasing colonoscopies ordered, scheduled, and completed.

Study participants were divided into two groups:

  1. Group 1 received reminders to schedule a colonoscopy. The attending doctors also received a reminder.
  2. Group 2 received reminders along with educational materials on CRC risk and the colonoscopy procedure, as did their doctors.

Promising Results and Implications

The study included 150 patients, evenly divided between the two groups. The primary outcome showed that both groups had similar rates of completed colonoscopies. However, both groups experienced a significant increase in the number of colonoscopies ordered, scheduled, and completed.

The multicomponent intervention successfully engaged high-risk individuals who had been hesitant about CRC screening. The combination of reminders for doctors and patients proved effective in increasing screening rates. Surprisingly, the additional educational materials did not significantly impact outcomes, suggesting that they may not be necessary in future interventions.

The study’s findings offer hope for improving CRC prevention and control in high-risk individuals with a family history of the disease. By refining and expanding this intervention, we can raise screening rates, detect CRC at an early stage, and potentially save lives.

Take Action

Regular screening is crucial for early detection of CRC. If you have a family history of CRC or are overdue for screening, consult your healthcare provider to discuss the best screening options for you. Together, we can fight CRC and make a meaningful impact on public health.

The Colon Cancer Foundation remains committed to supporting advancements in CRC prevention, early detection, and treatment. Join us in our mission to raise awareness and promote lifesaving screenings. 

Reference-
Impact of a Multicomponent Health System Intervention to Increase Colorectal Cancer Screening Participation in Patients with a Family History of Colorectal Cancer. Jain S, Galoosian A, Badiee J, Meshkat S, Popoola F; Presented at Digestive Disease Week 2023.

 

 Deepthi Nishi Velamuri is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation.

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Breaking Barriers: Effective Approaches for Boosting Colorectal Cancer Screening Rates

By Deepthi Nishi Velamuri

Colorectal cancer (CRC) remains a serious public health issue in the U.S. that affects people from all walks of life, independent of race, gender, or age. The third most commonly diagnosed cancer in the U.S., an estimated 150,000 new cases and 53,000 deaths are attributed to CRC each year, highlighting the urgency for effective prevention and early detection strategies. [1]

Early and regular screening can improve detection rates and lead to better outcomes for CRC. However, there are significant disparities in the rates of CRC screening for some groups, such as medically underserved communities. Race and ethnicity, socioeconomic status, and access to healthcare services have a significant impact on CRC screening rates . 

During the annual Digestive Disease Week 2023 meeting,  several research studies were presented that identify interventions to improve CRC screening rates, specifically in medically underserved populations. The following interventions were identified in the systematic review to increase CRC screening rates among medically underserved populations:

  1. Multicomponent interventions: These interventions involved multiple elements, such as patient education, provider reminders, patient navigators, and mailed outreach. [2][3]
  2. Patient navigation: Interventions that included the use of patient navigators, who assist patients in navigating the healthcare system and overcoming barriers to screening, were effective in increasing screening rates. [3]
  3. Mailed stool-based kits with provider letters: Sending screening kits to patients by mail, along with a letter from their healthcare provider recommending the screening, was found to be a successful intervention. [3]

Multiple Elements to a Successful Screening Program

The study conducted by Shailavi Jain et al., [3] highlighted the impact of a multicomponent health system intervention to increase screening participation among patients with a family history of CRC. This intervention involved:

  • Electronic health record reminders to primary care providers
  • Reminders to patients to schedule a colonoscopy
  • Additional educational resources about familial CRC risk and the colonoscopy procedure 

The intervention increased colonoscopies ordered, scheduled, and completed among high-risk patients.

Another study focused on using patient-level structured data elements to optimize population-based CRC screening. The study utilized individualized health data, such as laboratory results and diagnosis codes, to identify patients with significant comorbidities who were unlikely to complete routine screening. This approach allowed for targeted screening efforts to be directed towards patients most likely to complete screening as intended by their primary care team. [4]

A meta-analysis examined the efficacy of an opt-out outreach method  to optimize screenings. [5] This approach involved giving patients the option to either opt-in or opt-out of receiving fecal immunochemical test (FIT) kits. The analysis showed that patients who were given the option to opt-out had a significantly higher FIT completion rate compared to those who were given the option to opt-in. 

Additionally, a quality improvement project evaluated the effectiveness of mailed reminders in increasing uptake of FIT. Mailed reminders were found to be an effective strategy in improving screening rates. [6]

Overall, these studies highlight the effectiveness of various interventions, including multicomponent approaches, patient navigation, mailed reminders, and opt-out outreach methods in increasing CRC screening rates among medically underserved populations and individuals with a family history of CRC. These interventions can inform the design of programs aimed at improving CRC screening in these populations.

References-

  1. American Cancer Society.
  2. Vella J., Patel, S, Bowman B., et al. Interventions to improve colorectal cancer screening among medically underserved populations: A systematic review. In: Digestive Disease Week 2023; May 6-9, 2023; Chicago, IL.
  3. Jain S, Galoosian A, Badiee J., et al. Impact of a multicomponent health system intervention to increase colorectal cancer screening participation in patients with a family history of colorectal cancer: A systematic review. In: Digestive Disease Week 2023; May 6-9, 2023; Chicago, IL.
  4. Corren R., et al. Flagging comorbidities using patient-level structured data elements to optimize population-based colorectal cancer screening: A systematic review. In: Digestive Disease Week 2023; May 6-9, 2023; Chicago, IL.
  5. Battepati D., et al. The efficacy of opt-out outreach method to optimize colorectal cancer screenings: A systematic review and meta-analysis.: A systematic review. In: Digestive Disease Week 2023; May 6-9, 2023; Chicago, IL.
  6. Ahmad Abu-Heija, Abdelnour D, et al. Effectiveness of mailed reminders in increasing uptake of fecal immunochemical testing for colorectal cancer screening: A quality improvement project.: A systematic review. In: Digestive Disease Week 2023; May 6-9, 2023; Chicago, IL.

 

Deepthi Nishi Velamuri is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation.

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Impact of Social Media on Colon Cancer Screenings

Social media is a powerful tool that can be used to spread important information at unprecedented speed. Many users of TikTok, the short-form video app that has taken the world by storm, have utilized the platform to share their experiences with colonoscopy screenings. Users upload “vlogs” (video blogs) to the platform that document their entire experience in detail and talk to their audience throughout the process. While this may seem like oversharing, the authentic nature of these vlogs has grown popular on TikTok, as videos that do well on the platform often contain genuine and unfiltered content. 

One example of this is @lucindabinney‘s three-part video series:

@lucindabinney

Colonoscopy Vloggy Part 1 🧻🧻🧻 #colonoscopy #gutissues

♬ Just a Cloud Away – Pharrell Williams

 

@lucindabinney

Colonoscopy Prep Part 2 🧻🧻🧻 #colonoscopy #gutissues

♬ original sound – lucinda

 

@lucindabinney

Colonoscopy Part 3 🧻🧻🚽🚽 #colonoscopy #guthealth #gutissues

♬ original sound – lucinda

Lucinda Binney walks her audience through her experience with colonoscopy prep in a humorous, unfiltered manner that is popular among many lifestyle influencers. She details her experience with a liquid diet (she includes jello) and the standard practice of taking laxatives to prepare her colon for screening. Through this three-part vlog, she demystifies this screening procedure for her 340,000 followers, coming clean about both her anxiety surrounding the experience and her surprise that the laxative drink didn’t taste as bad as she thought. 

While it is uncommon for people in their 20s to receive colonoscopies, as the U.S. Preventive Services Task Force does not recommend them until age 45 (a recent change from the previous age 50 guideline), individuals at high risk for colorectal cancer (CRC) may benefit from receiving a screening. CRC rates in the younger population have risen dramatically in the past two decades, with incidence jumping from 2.7 people per 100,000 in the year 2000 to 5.0 per 100,000 in 2019 in the 15-to-39 age group. While these incidence rates are still not high enough to warrant routine screenings in the general young adult population, they help make the case for increased screenings among those at higher-risk. 

Haddon Pantel, MD, of Yale Medicine recommends that people in their 20s and 30s seek CRC screening if they experience any sudden changes in bowel movements, rectal bleeding, or any weight loss, abdominal pain, or appetite changes that are not otherwise explained. For more information about the signs of CRC, check out this resource. 

Emma Edwards is a Colon Cancer Prevention Intern with the Colon Cancer Foundation.

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CDC Report: Why Do Certain Populations Never Screen for Colorectal Cancer?

Cancer screening remains a powerful tool. Even limited screening has long-term benefits compared to no screening  and can lower the risk of cancer and related deaths. A recent study by researchers at the CDC compared data on adults who reported they had not received a colorectal cancer (CRC) screening test between 2012 and 2020 using information from the Behavioral Risk Factor Surveillance System (BRFSS). The study identified various trends, most notably that 22 states did not meet the CDC’s Healthy People 2020 goal of 70.5% adults screened for CRC.

The sample was limited to adults aged 50 to 75 years, with up to date screenings defined as one of the following:

  • Home stool-blood test within the past year
  • Sigmoidoscopy within five years with fecal occult blood test or within one year with fecal immunochemical test
  • Colonoscopy within ten years

The ‘never screened’ numbers were a composite of those who answered no to being screened or those who were not up to date. Those who declined to answer or reported uncertainty were excluded. Overall, the study identified:

  • A 5.8% decrease in unscreened adults between 2012 and 2020 
  • States with the largest improvements were also those with the largest unscreened population in 2012 

 

Despite these improvements, CRC screening goals have yet to be met and may be difficult to meet with the new Healthy People 2030 standards. The target of 74.4% screened may have been a challenge to meet, possibly further exacerbated by the COVID-19 pandemic.

Researchers noted that including just two more questions on the BRFSS in 2020, the percentage of up to date screenings increased to 71.6%. These two questions enquired about:

  • Stool DNA testing
  • Computerized tomographic colonography

It is important to note that the National Colorectal Cancer Roundtable—a membership organization established by the CDC and the American Cancer Society—has set its goal to 80% screening rates across the country.

Study authors recognized recall bias and an inability to distinguish between screening versus diagnostic tests as major study limitations. Additionally, social desirability bias and a low response rate may have also affected the results. However, financial factors and health disparities may also describe the differences between states.

Following implementation of the Affordable Care Act, researchers at the American Cancer Society found that CRC screening among low-income adults across the U.S. increased by up to 8%, with the greatest increases observed in early Medicaid expansion states. They also noted that a majority of those who were never screened also lived in a state without expansion (South Dakota). 

Nonfinancial factors such as health disparities were studied in a mixed-methods analysis conducted at the Virginia Commonwealth University’s School of Medicine. Here, researchers noted that participants of gender-specific and race-specific focus groups brought forth nuanced concerns regarding screening. This included lack of awareness of both the disease and the screening, lack of physician recommendation that is clear and rational, and fear of being diagnosed and complications associated with testing. These concerns, if unaddressed, may limit others from seeking out CRC screening.

To read more about the Healthy People 2030 CRC screening standards and the current progress, visit Healthy People 2030.

 

Kaylinn Escobar is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation. 

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Patient Preference Key to Success of Colorectal Cancer Screening Programs

Colorectal cancer (CRC) screening is a vital preventative method to detect and remove a polyp and to diagnose cancer before it advances to an incurable stage. CRC screening options include endoscopy and stool-based testing. Now a new study that surveyed unscreened individuals at average risk for CRC has found that people have a preference for the stool-based screening option. 

The third most diagnosed cancer in the U.S., over 5 million people worldwide currently live with CRC. One method of CRC screening is a colonoscopy, which detects swollen, abnormal tissues, polyps, or cancer in the large intestine (colon) and rectum. Another form of CRC screening is the fecal immunochemical test (FIT). FIT is one of the most widely used CRC screening methods globally and is an affordable screening tool for studying large populations. FIT detects hidden blood in stool, a potential early sign of cancer, and it has an overall 95% diagnostic accuracy for CRC. 

It is estimated that 106,180 new colon cancer cases and 44,850 new rectal cancer cases will be diagnosed in the U.S. in 2022. With the screening age for CRC for average-risk adults lowered to 45 years, we need a better understanding of what the various age groups may prefer as a screening option to improve compliance and screening rates. 

The new study that was published has found that individuals in the 40-49 age group and those ≥50 years prioritized test modality above effectiveness when choosing their screening test. The findings of this study demonstrate that:

  • Both 40-49-years-old and ≥50-year-old age groups preferred FIT-fecal DNA every three years
  • The second preferred test for both age groups was a colon video capsule, or capsule endoscopy, every five years 
  • Regarding only the USPSTF tier 1 tests, both age groups preferred an annual FIT over a colonoscopy every ten years
    • 68.9% of 40-49-year-olds and 77.4% of ≥50-year-old participants preferred an annual FIT

These results conflict with current CRC screening approaches in the U.S., where colonoscopy is the screening test customarily used. Furthermore, these findings prompt the modification of current CRC screening guidelines and suggest that healthcare providers consider sequential-based screening procedures where FIT is offered before colonoscopy. The results, however, are consistent with a 2007 study, which supports the effectiveness of providing FIT before colonoscopy—the percentage of patients that were up-to-date with screening increased by almost 50% between 2000 and 2015 when they were offered direct-to-patient annual FIT outreach with colonoscopy. 

Scheduling delays and longer waiting times for colonoscopies have increased as millions of newly eligible individuals need a colonoscopy, all of which can strain resources and delay access and early screening for patients, especially for those at greater risk for CRC. Sequential approaches for CRC screening, such as those that offer FIT before colonoscopy, can help acknowledge and adjust to the increased need for screening and the lack of resources and help prioritize access to colonoscopy for those at greater risk for CRC.

 

Sahar Alam is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation.

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Setting it Straight: The Colonoscopy Controversy

A new study published in the New England Journal of Medicine has sparked controversy—this 10-year study involving nearly 85,000 participants in Europe highlighted that colonoscopies cut the risk of colorectal cancer (CRC) only by about a fifth, far below estimates from earlier scientific studies, and didn’t substantially reduce deaths, raising the possibility that the invasive procedure is not worth it. Doctors in the U.S. are now concerned that the study’s results could cause doubt about the effectiveness of a colonoscopy, which is a recommended CRC screening approach for those 45 and older, to be conducted once in ten years. Despite the confusion about the effectiveness of colonoscopies, national news articles and gastroenterologists in the U.S. have rebuked these conclusions. 

A major limitation that experts found with the study was that only 42% of the people who were invited to get a colonoscopy actually had one. However, researchers still reported the outcomes for the entire cohort, regardless of whether or not they underwent a colonoscopy. The study found that of those who were invited to have a colonoscopy—whether they got it or not—there was an 18% reduction in developing the disease and no statistically significant reduction in the likelihood of CRC death. Many don’t believe that this is representative of what happens in the U.S., where colonoscopy is more widely accepted as a standard screening protocol compared to European countries, and was a serious shortcoming of the study. In fact, when the individuals who did not get a colonoscopy were removed from the study, the risk of developing CRC among those who did get a colonoscopy reduced by an estimated 31% and the risk of death reduced by about 50%.

As Robin Mendelsohn, MD, co-director of the Center for Young Onset Colorectal and Gastrointestinal Cancers at the Memorial Sloan Kettering Cancer Center, argues “in order for a colonoscopy to be effective, you have to have it done”.

Andrew Albert, MD, a member of the Colon Cancer Foundation (CCF)’s Interdisciplinary Medical Advisory Council (IMAC), said, “While the NordICC trial demonstrates the need for challenging the status quo related to colonoscopy, this remains an effective screening tool, particularly for individuals at average risk who may be on the fence about going in for screening. Misinformation is dangerous, especially in healthcare. If we miss catching colorectal cancer at an early stage—which is what a colonoscopy is very good at—it can have a big impact on survival. We need to remember that CRC is preventable, and treatable when caught early.”

IMAC member Matthew A. Weissman, MD, MBA, FAAP, told CCF, “I hope that the findings of this study, which have been taken out of context by many, will not discourage folks from getting screened for colon cancer by colonoscopy or other appropriate methods, which is extremely important in early detection (and prevention) of this deadly disease.”

In an accompanying editorial in the same issue, experts point to the need for a longer follow-up time for the impact of screening colonoscopy to be realized. They also point out that the skill of the endoscopist conducting the procedure has a significant impact on the detection rate—29% of endoscopists in the trial had an adenoma detection rate below the recommended 25%. 

Consequent to this study, the American Society for Gastrointestinal Endoscopy (ASGE) issued a public statement that colonoscopy remains the best and most proven way to detect and prevent CRC incidence and death. The American Cancer Society also weighed in on the study, pointing to the high number of participants who didn’t undergo the procedure. Adam Lessne, MD, a gastroenterologist at Gastro Health in Florida told VeryWell Health that “when you take away the limitations, it’s proven again that colonoscopies do save lives and they do reduce the risk of death.” 

The bottom line is that a screening test of any kind—stool-based or colonoscopy—is better than none, and CRC is preventable with regular screening. For detailed information on various CRC screening methods and current screening guidelines, visit this page on the Colon Cancer Foundation’s website. 

 

Kitty Chiu is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation.

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Lessons Learnt: COVID-19 Pandemic Impacted FIT Testing in the Early Days

Globally, the COVID-19 pandemic has led to sharp declines in cancer screening rates. Screening tests were halted as national lockdowns began as healthcare centers needed to prioritize COVID-19 patients. A retrospective cohort study revealed that during the early days of the pandemic in 2020, fewer fecal immunochemical test (FIT) screenings and colonoscopies resulted in fewer patients being diagnosed with colorectal cancer (CRC) and advanced adenomas than in 2019. In April 2020, colonoscopy volumes were significantly lower than in April 2019, with a 26.9% decrease in colonoscopy volume. Overall, there was an 8.7% reduction in CRC cases diagnosed by colonoscopy in 2020. This has fueled concerns of a potential negative impact on cancer prevention and care.

The study mentioned above analyzed the effect of the COVID-19 pandemic on CRC screening and diagnostic testing among 18-89 year-olds enrolled in the Kaiser Permanente Northern California health plan in 2019 and 2020. Researchers measured changes in the number of mailed, completed, and positive FITs; colonoscopies; and cases of colorectal neoplasia detected by colonoscopy. Findings show that when the pandemic-related stay-at-home orders were issued in March 2020, there was a dramatic decline in FIT mailings. Similarly, in South Australia, retrospective analysis on surveillance colonoscopy in patients at high risk for CRC revealed that there was a 51.1% decrease in surveillance colonoscopy procedures from April–June 2019 compared to April–June 2020, the period where the region faced the most difficulty due to COVID-19. 

The reduction in CRC screenings during the pandemic suggests that patients may have been reluctant or unable to undergo screening. Furthermore, challenges with pre-pandemic CRC screening were amplified during the pandemic. For instance, stress levels in the general population increased and those who may have skipped screening due to work obligations were more likely to miss setting up a colonoscopy during the pandemic. Fear of contracting COVID-19 may have been another barrier. Another issue that was evident during the pandemic was healthcare inequities that disproportionately impacted medically-underserved communities. 

Given the massive delays in traditional methods of screening, healthcare centers had to develop alternative approaches to ensure continued screening after the initial wave of COVID-19, such as the increased adoption of telehealth services. For CRC screening, the use of FIT was arguably the best alternative to colonoscopy procedures during the COVID-19 pandemic. This remote option gives patients a lot of flexibility with their screening, as they are able to take the test safely in the comfort of their own homes. 

These findings may help inform the development of strategies for CRC screening and diagnostic testing during future national emergencies. 

 

Kitty Chiu is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation. 

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Ryan Reynolds Documents a “Potentially Life-Saving” Colonoscopy After Losing a Bet

A friendly bet resulted in a potentially life-saving procedure for actors Ryan Reynolds and Rob McElhenney. Reynolds bet McElhenney that if he learned to speak Welsh, Reynolds would let a camera crew document him as he underwent a colonoscopy. In partnership with Lead from Behind, Reynolds documented and shared his experience on YouTube. 

Both Reynolds and McElhenney turned 45-years-old this year. In May 2021, the US Preventive Services Task Force (USPSTF) revised the colorectal cancer (CRC) screening age for average-risk adults to 45 years instead of 50. Reynolds noted in his video description, “I made a bet. I lost. But it still paid off.” Reynolds’ colonoscopy, conducted by Jonathan LaPook, MD, a gastroenterologist with NYU Langone’s Colon Cancer Screening and Prevention Program, resulted in the detection and removal of an “extremely subtle polyp” on the right side of his colon. McElhenney also decided to undergo a colonoscopy, which resulted in the identification of three polyps. Dr. LaPook emphasized, “This [colonoscopy] saves lives. Pure and simple.”

Importance of Colorectal Cancer Screening

Colorectal cancer (CRC) is the third most diagnosed cancer and over 5 million people worldwide currently live with CRC. According to the American Cancer Society, the lifetime risk of developing CRC is 1 in 23 for men and 1 in 25 for women, and recent research indicates an increased incidence of CRC among individuals younger than 50 years of age. There will be an estimated 106,180 new colon cancer cases and 44,850 new rectal cancer cases in the United States in 2022. While CRC screening rates have significantly improved over the past 20 years, only 65%-70% of age-eligible individuals achieve screening nationally. Screening is a significantly effective and preventive method to detect CRC before it advances to an incurable stage. 

When to Schedule a Colonoscopy

The American Cancer Society and USPSTF recommend screening should begin at 45 years for average-risk adults. Individuals who are at a higher risk of developing CRC may need to be screened earlier.

What to Expect During a Colonoscopy

A colonoscopy detects swollen, abnormal tissues, polyps, or cancer in the large intestine (colon) and rectum. Before a colonoscopy, patients are required to empty their colon by following a specific diet recommended by their doctor, taking a prescribed laxative, and adjusting any daily medications as instructed by their doctor. On the day of the procedure, a long, flexible tube (colonoscope) is inserted into the patient’s rectum under anesthesia. A tiny camera at the tip of the tube allows the doctor to view the colon. If polyps and abnormal tissues are detected, they can be removed during the colonoscopy itself, just like in Reynolds’ and McElhenney’s procedures. According to the American Society for Gastrointestinal Endoscopy, more than 40% of adults over the age of 50 years have precancerous polyps in the colon.  

What Are Colorectal Cancer Symptoms?

CRC may not cause symptoms immediately. Screening is the most effective method to detect and remove polyps before they advance into malignant disease. Speak to your doctor if you are 45 or older, have a family history of CRC, or notice any abnormal symptoms.

Remember: CRC survival is 90% if detected at an early stage when the cancer is localized and has not spread to other sites or organs.

Sahar Alam is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation.

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