Colon cancer is the second most deadly cancer after lung cancer. You may be a little confused by recent messages about colon cancer screening, and that’s understandable. In August, the American College of Physicians (ACP) issued the following announcement: Updated guidance We offer colon cancer screening unlike any other leading organization, including recommendations from the American Cancer Society (ACS) and the United States Preventive Services Task Force (USPSTF).
So what do you need to know?
How is the advice different?
First, note that this advice applies. only It is for people with no family history of colon cancer and who are at average risk. If you have a family history or other health problems that put you at higher than average risk for colorectal cancer, talk to your doctor about the best course of action for you.
The main point of disagreement relates to the age at which people should start getting tested. New ACP guidance says he is 50 years old, but his two other organizations recommend he be 45 years old. This earlier age is supported by the ACP. U.S. Multisociety Task Force on Colorectal Cancer. It is also endorsed by many physicians, including Dr. Andrew T. Chan, professor of medicine at Harvard Medical School, gastroenterologist, and director of epidemiology at Massachusetts General Hospital Cancer Center, who provides the following key facts: It helps explain.
Why do experts recommend starting screening early?
“We are facing an alarming and unexplained increase in the incidence of colon cancer in people under 50,” says Dr. Chan.
Overall, colon cancer deaths decreased by 2% annually from 2011 to 2020. However, this does not apply to people under 50 years of age. In that age group, deaths from colon cancer increased by 0.5% to 3% over the same period.according to Statistics to be released in 2023.
The increasing incidence of colon cancer in young people is occurring in all racial and ethnic groups, with the steepest increases occurring among Alaska Natives and American Indians. Overall, blacks and African Americans are more likely to develop and die from colon cancer than whites, and early-onset cases are higher in blacks than whites.
Efforts to encourage colon cancer screening began in the mid-1990s. Currently, approximately 60% of adults over the age of 50 follow the advice to have regular colonoscopies (see below). Although this track record is not perfect, it may explain the decline in colon cancer deaths among older adults.
“I think promoting early screening will help stop the rise in cases in young people, at least in their 40s. Also, getting a colonoscopy early can help prevent colon cancer later in life. “We also know that it may be associated with lower incidence of cancer,” he says. Dr. Chan.
What are the different screening tests for colon cancer?
The two most widely used screening tests are a standard colonoscopy and various stool-based tests.
Colonoscopy. For this test, your gastroenterologist or surgeon passes a long, flexible tube with a camera at the end into your rectum to examine the entire length of your colon. Considered the gold standard test, this procedure can detect precancerous polyps called adenomas and remove them.
This test requires you to take laxatives and drink lots of fluids beforehand to remove all fecal material (feces) from your colon. Serious complications, such as perforation or bleeding, are rare and occur within about a year. 3 in 1,000 procedures. If no polyps were found, it is not recommended to repeat the colonoscopy for another 10 years. This interval will be shorter if you have polyps or if your risk or symptoms change.
Stool test. Even more concerning, colon polyps (adenomas) often pass small amounts of blood and abnormal DNA into the stool. This can be detected from samples taken by yourself at home.
- Two tests are used to check for the presence of blood: the fecal occult blood test (FOBT) and the fecal immunochemical test (FIT). You will need to mail a small stool sample to the lab on a card or tube. These tests must be performed annually.
- The third option, the FIT-DNA test, checks for both blood and abnormal DNA. Usually he is repeated every 3 years.
Additionally, the American College of Physicians guidelines suggest another option. flexible sigmoidoscopy, Only the lower part of the colon is tested once every 10 years, combined with a fecal FIT test every two years. But now, doctors in the U.S. rarely order a sigmoidoscopy for her.
If a flexible sigmoidoscopy or one of these stool tests shows evidence of a problem, a colonoscopy is required to check for an adenoma or cancer.
Why does stool-based screening make sense for young adults?
Colonoscopy isn’t necessarily the best initial screening test for everyone, Dr. Chan says. This is especially true for young people, mainly because it is time consuming and inconvenient.
“Maybe you just don’t have time in your schedule or are worried about getting a colonoscopy,” he says. In that case, a stool-based test may be a good option as it is non-invasive and takes little time.
“The worst option is to do nothing, because early detection and treatment can prevent death,” he says.