Colon and rectal cancers have long been considered diseases of the elderly. And it is true that most people who are diagnosed are between the ages of 65 and 74 years. But new research shows that these cancers are rising quickly in adults as young as 20.
The colon (about five feet in length) and the rectum (about six inches in length) together make up the large intestine. Cancers here are collectively referred to as colorectal cancers, and they have a high cure rate when caught early.
For years, 50 has been the recommended age to start screening for the disease. And likely due to this advice, the rate of colorectal cancer has steadily dropped in the U.S. over the last several decades. That is, except for people born after 1950.
A study published last month (February 2017) in the Journal of the National Cancer Institute, looked at nearly 500,000 cases of colorectal cancer over a 40 year period. The authors found that rates of colorectal cancer dropped in that time for patients born between 1890 and 1950. But for those born since 1950, the rate went up, especially with rectal cancer. According to the authors,
The proportion of rectal cancer diagnosed in adults younger than age 55 years has doubled in just two decades.
This new information on age distribution is not yet reflected in cancer-screening guidelines. In the meantime, the researchers recommend younger patients get screened, as that is the most effective way to slow down rates of colorectal cancer. The American Cancer Society estimates that 50,260 people will die from both rectal and colon cancer in 2017. Many of these deaths can be prevented with early screening.
“One third of eligible adults in the US have never been screened for colorectal cancer,” states The U.S. Preventive Services Task Force in recommendations released last June (2016). This may be remedied, they say, by the many new screening methods available today. In other words, colonoscopy is not the only recommended way to get screened.
We’re going to repeat that: Colonoscopy is not the only recommended way to get screened.
The American College of Gastroenterology does say that a colonoscopy is their preferred screening test, but they, and the U.S. Preventive Services Task Force, also recommend a number of other tests. The tests most commonly used to screen for colorectal cancer are listed below:
Colonoscopy–The full colon is visualized using a camera on the end of scope. Performed under anesthesia. Complete emptying of the colon is required. Recommended every 10 years.
Fecal Immunochemical tests (FITs)— Requires a simple stool sample. If blood is found in the stool, further testing is urged. Recommended yearly.
Fecal Occult Blood Test (gFOBT)— Requires a stool sample that can be given in a take-home kit. Also looking for blood in the stool. Recommendations vary
CT Colonography— X-rays designed to look for polyps and cancers in the colon and rectum. Recommended every 5 years.
Flexible sigmoidoscopy— The lower half of the colon is visualized. Does not necessarily require anesthesia. Complete emptying of the colon is required. Recommended every 5-10 years.
Fecal-DNA— Stool sample required. May be done in a take-home kit. This test looks for genetic signs of cancer in the stool. Recommended every 3 years.
It is important to point out that the tests mentioned are recommended for screening and not necessarily for diagnosing colorectal cancer. Many of the same tests are used as part of a larger effort to come up with a diagnosis when patients report symptoms associated with colorectal cancer. These symptoms include changes in bowel habits (diarrhea or constipation), pain in the abdomen, or blood in the stool.
If you want to learn more about these screening tests and which one might be right for you, contact us to make an appointment today.
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