Colorectal Cancer Screening

In fact, the five-year relative survival rate for a person diagnosed with early-stage colorectal cancer is 91%. In contrast, the survival rate for someone whose cancer is diagnosed after it has spread to distant parts of the body is 14%. And with just over a third of colorectal cancers diagnosed in the early stages, there’s a lot of room for improvement in terms of colorectal cancer screening rates.

All adults at average risk should begin a colorectal cancer screening regimen at age 45. Screening should continue until at least age 75 and, for some individuals, until 85, depending on their doctor’s recommendation.

People who are at high risk for developing colorectal cancer should talk to their doctors about beginning colorectal cancer screening earlier and/or being screened more frequently. You are considered to be at high risk if you:

• Have a first-degree relative who has had colorectal cancer and/or colorectal polyps (growths inside the bowel that sometimes develop into cancer).
• Have a history of inflammatory bowel disease.
• Have been diagnosed with certain hereditary conditions, such as Lynch syndrome or familial adenomatous polyposis.

At Winship, we have a team of expert endoscopists that can remove large precancerous polyps endoscopically, which often results in avoiding surgery. And our team of physicians, nurses and technicians are specially trained to manage very complex disease states such as familial polyposis syndrome and inflammatory bowel disease.

Colorectal cancer is unique in that there are several different tests that are used to screen for the disease, some of which can actually prevent cancer from developing. You should work with your doctor to determine which colorectal cancer screening test is right for you.

Colonoscopy

Colonoscopy is the most comprehensive colorectal cancer screening tool available today. The exam is performed under sedation. It involves a physician inserting a long, thin tube through the anus to examine the rectum and colon for cancer or polyps. If polyps are observed, the physician can remove them to prevent them from growing and developing into cancer. Regular screening with colonoscopy can actually reduce your chances of developing colorectal cancer by up to 70%. Colonoscopy is repeated every 10 years in people at average risk.

Flexible Sigmoidoscopy

This colorectal cancer screening exam is similar to the colonoscopy except the physician uses a shorter, flexible tube to check only the rectum and lower colon for cancer and polyps. Physicians can also remove polyps during this exam, thereby preventing cancer. However, because only a portion of the colon is examined with this test, it has less of an effect on incidence rates. Flexible sigmoidoscopy is associated with a 20-25% reduction in colorectal cancer risk. This test should be repeated every five years or every 10 years if used in combination with an annual fecal immunochemical test.

Stool Tests

Another colorectal cancer screening option involves sending a stool sample to a laboratory for testing. There are three types of lab tests for colorectal cancer:

• Guaiac-based fecal occult blood test. This test checks for blood in the stool, a possible indication of colorectal cancer. You will be provided a test kit and take it home, where you’ll collect and package a small amount of stool. The kit is then returned to the lab where it’s tested. This screening should be done annually.
• Fecal immunochemical test (FIT). Stool for this test is collected in the same manner as above. It uses antibodies to detect blood in the stool. It also needs to be done once a year.
• FIT-DNA test. Also referred to as the stool DNA test, this test checks for blood as well as altered DNA in the stool. You’ll need to collect and submit an entire bowel movement to the lab for testing. This test should be completed every three years.

If you are at high risk for colorectal cancer, you may qualify to take part in Winship Cancer Institute’s high-risk gastrointestinal cancer clinic. Based on your individual risk, a team of Winship colorectal cancer experts will design a customized screening regimen that outlines which type of screening is best for you, when you should begin and how often you’ll need to repeat screening. Your screenings are performed, reviewed and analyzed by radiologists and oncologists who specialize in colorectal cancers. The clinic will then send you reminders when it’s time for your screenings.

If you have a first-degree relative who’s been diagnosed with colorectal cancer or colorectal polyps or you have been diagnosed with Lynch syndrome or familial adenomatous polyposis, you may benefit from Winship’s high-risk gastrointestinal cancer clinic. To learn more, please call (404) 778-0032.