Colorectal (colon) cancer

Colorectal cancer, often referred to as colon cancer, is the second most common cause of cancer death in the United States, yet it is one of the few cancers that is easily preventable. Ninety percent of patients with colon cancer will survive if it is found early enough. Screening is the best way to prevent colon cancer.

At what age should screenings for colon cancer begin?

The biggest change in colon cancer screenings is lowering the screening age from 50 to 45. Why? There has been a trend across the country of increased diagnosis of colon cancer at younger ages, such that 10-15% of all colon cancers are now found in 45-50 year-olds. Screenings may sometimes be started earlier if there is a family history.

What screening options are available?

The most accurate method for diagnosing and evaluating colon and rectal processes is a colonoscopy, which allows for both diagnosis and treatment of polyps. This screening test should also be performed if you are experiencing symptoms such as rectal bleeding, weight loss or a change in your bowel habits.

There are a few additional ways to screen for polyps and colon cancer:

• Stool based tests (FIT and Cologuard)*
• Flexible sigmoidoscopy*
• CT colonography (not widely available)*

*If any of these tests yield positive results, a full colonoscopy will be needed.

Does insurance cover the cost of screenings?

In general a screening test is covered by insurance. Every insurance provider, including Medicare and Medicaid, has different policies regarding coverage for screening, and you must check with your specific provider regarding your actual coverage, especially if you are between 45 and 50.

What are the risk factors and symptoms for colon cancer?

Screening should be done before any symptoms of colon cancer develop. The goal is to prevent colon cancer from ever developing by removing polyps before they become malignant. Colon cancer can happen in anyone, but some known risk factors are family history, lack of physical activity, being overweight, a diet with low levels of fiber, vegetables and fruit, as well as alcohol and tobacco use.

In addition to following screening recommendations, it is also important to be aware of warning signs that colon cancer may be developing and talk with your physician. The most common symptoms include changes in your usual bowel habits, blood in the stool, new and persistent abdominal pain or gas, persistent thin stools, feeling like you are unable to empty the bowels, and weight loss.

What are treatment options for colon cancer?

There are many treatment options for colon cancer. They can range from as simple as endoscopic to surgical options. Often, radiologic scans are performed to accurately stage the cancer prior to surgery. Laparoscopic or robotic-assisted surgery is frequently used to perform bowel resection. Occasionally, an open approach or diverting ostomy is required. Some patients may undergo additional treatment, such as radiation and chemotherapy. A multidisciplinary approach is used to provide individualized patient care.

What is important is that the number of effective options has increased dramatically in recent years making it all the more important to screen.