1. I have no bowel problems, why do my doctors recommend me to have a colorectal cancer screening?
The majority of patients with early stage colon cancer do not have bowel problems. Colorectal cancer screenings are the most effective ways to detect early stages of cancer before they progress further to cause symptoms. Some screening tests, such as a colonoscopy, also prevent cancer by detecting precancerous changes.
2. What is colorectal cancer?
Colorectal cancer is type of malignant tumor originating from abnormal growth of the cells that line the surface of parts of the lower gastrointestinal tract, i.e., the colon and the rectum. Colorectal cancer is the fourth most common cancer in both men and women and the second leading cause of cancer death in the U.S.
3. Am I at the age for colorectal cancer screening?
Generally, professional societies recommend beginning colorectal cancer screening tests at age 50, if no one in your family has been diagnosed with colon cancer, certain type of colon polyps, or several conditions associated with increased risks of colorectal cancer. Additionally, the American College of Gastroenterology recommends screening at age 45, rather than 50, for African Americans, preferably by colonoscopy. However, physicians are not in complete agreement about this recommendation. The decision to continue screenings after age 75 should be made on individual basis. I encourage you to discuss your risk with your doctors.
4. What colorectal cancer screening test(s) should I choose?
A variety of tests are used for colorectal screening including those designed to tests blood or abnormal DNA in stool, x-ray with contrast enema of the colon and rectum, and direct visualization of the colon and rectum. However, if you have significant family history of colorectal cancer or certain type of polyps in close relatives, a colonoscopy is recommended. Screening tests can be divided into two groups: (1) Those that primarily detect early cancer and (2) those that detect early cancer and adenomatous polyps, e.g. colonoscopies. Because some adenomatous polyps are precursors to colorectal cancer, the second group of tests may have greater advantage and potential for colorectal cancer prevention. Education on these two types of screening tests is important and you should discuss each with your doctors before making a final decision on which is best.
5. I am fearful of getting a colonoscopy so I have put it off. Is this common?
In a study published in American Journal of Preventive Medicine, the top patient-reported barrier to colonoscopy was “fear.” According to the same study, female patients have a greater fear of getting a colonoscopy than males. It is important to understand the general noninvasive nature of colonoscopies, and the relative low risk of the colonoscopy for most of the population. Your primary care physician or gastroenterologist can address any additional concerns you may have with the procedure.
M. Chris Huang, MD, is a gastroenterologist on staff at Barnes-Jewish St. Peters Hospital. She practices in two convenient locations, at BJC Medical Group at St. Peters, which is located at 201 BJC St Peters Drive, Suite 200. She also practices in Wentzville at 801 Medical Drive, Suite 400. Both practices can be easily reached at 636-916-9615.