Steven R. Peiken, MD, FACG, AGAF
Division Head of Gastroenterology and Liver Disease
Cooper University Health Care
Despite great strides in the early detection and treatment of colorectal cancer, the American Cancer Society estimates that more than 50,000 will lose their battle to the disease in 2014.
The good news is the number of deaths from colorectal continues to fall. There are several reasons for this. For one, polyps are being found by screening and removed before they can develop into cancer. Screening is also helping physicians find colorectal cancers earlier when the disease responds better to treatment.
There are several methods of screening the colon endorsed by the American Cancer Society (ACS) and the American Gastroenterological Society (AGS). The gold standard is colonoscopy. It is recommended once every 10 years for those over the age of 50 who have normal risk and are asymptomatic Your doctor may recommend more frequent tests if you have a family history of colorectal cancer or have had polyps removed previously.
Even though colonoscopy is painless, only about a third of patients who should be getting it take advantage of the screening. Others simply put the test off or are embarrassed. This is unfortunate because colorectal cancer is the second most deadly cancer for men and women combined. Colorectal cancer is preventable, however, when polyps are detected and removed before they develop into cancer. Unfortunately, because symptoms of colorectal cancer may not appear until late in the disease or be mistaken for other conditions, it is often difficult to cure once it is diagnosed.
While colonoscopy is best, an alternate screening method is the fecal immunochemical test (FIT). FIT screening is a newer kind of test that detects occult (hidden) blood in the stool. FIT test kits are often given to patients at doctors’ offices with instructions on how to complete the test in the comfort and privacy of their home. While not a replacement for colonoscopy, the FIT test has an 80 percent rate of detection of abnormalities when performed correctly.
FIT testing should be done annually. If results are positive for blood in the stool, the patient should see their doctor to schedule further tests. With the FIT test, there are very few false positives, making it a good screening tool for those who haven’t had a colonoscopy.
Risk Factors for Colorectal Cancer
While the exact cause of colorectal cancer is unknown, there are some factors that can increase a person’s risk of developing the disease:
- Age: About nine out of 10 people diagnosed with colorectal cancer are 50 or older.
- Family history: Parents, siblings and children of a person who has had colorectal cancer are more likely to develop the disease themselves.
- Diet: A diet high in fat and cholesterol and low in fiber has been linked to a higher risk of developing colorectal cancer.
- Lifestyle factors: You may be at an increased risk if you drink alcohol, smoke, don’t get enough exercise or if you are overweight.
Sometimes called the silent killer, colon cancer often has no symptoms. That is why being tested is so important. When symptoms are present, they can include:
- Changes in your bowel habits.
- Constipation and/or diarrhea.
- Rectal bleeding or blood in your stool.
- Abdominal bloating, cramps or discomfort.
- A feeling that your bowel doesn’t completely empty.
- Stools that are thinner than normal.
- Weakness and fatigue.
- Unintended weight loss.
Many of these symptoms are often caused by conditions other than colorectal cancer, such as hemorrhoids, irritable bowel syndrome, chronic constipation or inflammatory bowel disease. However, if you have any of these symptoms, it is important to see your doctor immediately so the cause can be identified and treated.