Colorectal Cancer: The Benefits of Screening and Early Detection

What you should know about colorectal cancer

Colorectal cancer is one of the most common cancers in older adults, but it can also affect younger people. Learning about the risks and symptoms to watch out for is important for early detection. Getting screened can help detect it sooner and improve treatment outcomes.

Understanding colorectal cancer and colon polyps

Colorectal cancer starts when cells in the colon or rectum grow out of control. The colon is the large intestine. The rectum connects the colon to the anus. Most colorectal cancers start as colon polyps. Polyps are small growths on the inside lining of the colon or rectum. Not all polyps are cancerous, but some types can turn into cancer over time.¹

There are different kinds of polyps. Adenomatous polyps, also called adenomas, are the type that can turn into cancer. The good news is that doctors can find and remove polyps during screening, which may help prevent colon cancer. This is why getting checked regularly is important for catching colon cancer early.¹

Risk factors you may want to consider

Some things may raise your chance of getting colorectal cancer. We want to share these with you because knowing your personal risk may help you make informed choices about screening.²

Age

The risk of colorectal cancer goes up with age. Most cases happen in people over 50, although young adults can also get this cancer. Health care providers often recommend starting screening around age 45 for individuals at average risk.²

Family history of colon cancer

Having a family history of colon cancer or certain types of polyps may raise your risk. If a close family member had colorectal cancer or adenomatous polyps, your risk might be higher. Your doctor might want you to start screening sooner or more often if this applies to you.²

Personal health history

A personal history of colorectal polyps, colorectal cancer or inflammatory bowel disease may raise your risk. Inflammatory bowel disease includes ulcerative colitis and Crohn's disease. People with these conditions might need to get screenings more often.²

Genetic markers for colorectal cancer

Some people are born with certain genes that make them more likely to get colorectal cancer. Two examples are Lynch syndrome and familial adenomatous polyposis. These are conditions that can run in families. If lots of people in your family have had colorectal cancer, your doctor might recommend a test to see if you have these genes. The test can show if you have changes in your genes that could raise your risk of getting colorectal cancer.³

If genetic testing shows you have one of these conditions, you may be able to take steps that could help prevent cancer or find it early. Early cancer may be easier to treat. Steps might include starting screening at a younger age and more frequent testing.³

Lifestyle factors

Certain lifestyle choices may affect colorectal cancer risk. These include not getting much physical activity, eating a lot of red or processed meats, being overweight, smoking and drinking a lot of alcohol. While we cannot control all risk factors, making healthy lifestyle changes might help lower your risk.²

Colorectal cancer screening options that could help with early detection

Colorectal cancer screening looks for cancer early, when treatment may work better. It can also find polyps before they turn into cancer. We want you to be aware of the available screening options. Your doctor can help you decide which colorectal cancer screening test might be best for you.³

Colonoscopy

A colonoscopy is a test where a doctor uses a thin, flexible tube with a camera to look inside your colon and rectum. The doctor can see the entire colon and remove polyps if any are found. Many health care providers consider colonoscopy an important option for colorectal cancer screening.³

The test is usually done with medicine to help you relax and feel comfortable. You will need to clean out your colon the day before. This means taking a prescribed medication to rid the colon of stool. If no polyps are found and you are at average risk, you might not need another colonoscopy for 10 years.³

Stool-based test

Stool-based tests check for signs of cancer or polyps in a stool sample that you collect at home. These tests are less invasive than a colonoscopy. They do not require the same preparation. However, if the test finds something concerning, you will need a follow-up colonoscopy.³

Stool FIT test

The stool FIT test (fecal immunochemical test) looks for hidden blood in your stool. This can be a sign of polyps or cancer. You collect a small stool sample at home and send it to a lab. This test is usually done every year. The stool FIT test may be a good option for people who want a simple screening method.³

Cologuard^® test

The Cologuard test is a type of stool DNA test. It looks for both blood and certain DNA changes in your stool that might mean cancer or polyps. Like the FIT test, you collect a stool sample at home. The Cologuard test is usually done every three years if results are normal. Some people may prefer this test because it is done at home and does not require the preparation that a colonoscopy does.⁴

Other screening options

Other screening tests include flexible sigmoidoscopy and CT colonography. Flexible sigmoidoscopy looks at only part of the colon. CT colonography is sometimes referred to as virtual colonoscopy. It uses X-rays to create pictures of the colon. Your doctor can explain which test might work best for your situation.³

Symptoms that may be worth discussing with your doctor

Early colorectal cancer often does not cause symptoms. This is why screening is so important. However, when colon cancer symptoms do show up, we suggest paying attention and talking to your doctor. Here are some signs that may be worth mentioning:⁵

• Changes in bowel habits that last more than a few days. This includes diarrhea, constipation or stools that are narrower than usual.

• A feeling that you need to have a bowel movement that does not go away after you go.

• Rectal bleeding or blood in your stool.

• Cramping or belly pain that does not go away.

• Weakness or feeling very tired.

• Losing weight without trying.

We want you to know that these symptoms can be caused by many conditions other than cancer. However, if you are experiencing any of these, we recommend consulting your physician. Do not wait for your next scheduled screening if you notice these changes.⁵

Colorectal cancer treatment approaches your health care team might discuss

If colorectal cancer is found, your health care team will work with you to create a treatment plan. Colorectal cancer treatment depends on several things. These include the stage of cancer, the site of cancer and your overall health. We want to share information about treatment options that your physician might discuss with you.⁶

Surgery

Surgery is often the main treatment for early-stage colorectal cancer. The surgeon removes the cancer along with some healthy tissue around it. For small, early cancers or polyps, this might be done during a colonoscopy. For larger cancers, more surgery may be needed to remove part of the colon or rectum.⁶

Chemotherapy

Chemotherapy uses drugs to kill cancer cells. It may be used before surgery to reduce tumor size. It might be used after surgery to kill any remaining cancer cells. Or it might be the main treatment if surgery is not an option. Your doctor will explain if chemotherapy might be helpful in your situation.⁶

Radiation therapy

Radiation therapy uses high energy rays to kill cancer cells. It is used more often for rectal cancer than colon cancer. Radiation might be given before surgery to make a tumor smaller. It might also be given after surgery to kill remaining cancer cells.⁶

Targeted therapy and immunotherapy

Newer treatments target specific parts of cancer cells or help your immune system fight cancer. These might be options for advanced colorectal cancer or cancers with certain genetic changes. Your oncologist (cancer specialist) can tell you if these treatments might be right for you.⁷

Here is a suggestion that may help: Ask your health care team questions about your treatment options. It may help to bring a family member or friend to appointments to help you remember the information discussed.⁶

Final thoughts from Dr. T

Colorectal cancer is a serious condition. We want you to know that getting screened early can help you stay healthy. Regular screenings can help find cancer sooner, when it may be easier to treat. These screenings can even prevent cancer by finding and removing growths called polyps, before they turn into cancer.

We suggest talking to your doctor about when you should start screening and which test might be right for you. If someone in your family has had colon cancer, or if you have certain genes or other factors that raise your risk, your doctor might want you to start screening earlier or more often.

Remember, whether you choose a colonoscopy, the Cologuard test, the stool FIT test or another screening option, the most important thing is to get screened. Do not put it off. Early detection of colon cancer could save your life.

If you notice any signs of colon cancer or are worried about risk factors, we encourage you to talk to your doctor. They are there to help and can provide guidance that is right for you.

Share this article: