Colorectal Cancer

While there not a sure way to prevent colorectal cancer, screening can help find indications of cancer. Addressing risk factors can also help lower risk for colorectal cancer.

Some people with colorectal polyps or colorectal cancer have symptoms which may include:

• Change in your bowel habits
• Blood in or on your stool (bowel movement)
• Stomach pain, aches, or cramps that don’t go away
• Unexplained weight loss

If you have any of these symptoms, talk to your health care provider. These symptoms may be caused by something other than cancer. However, the only way to know for sure is to see your health care provider.

What if I don’t have symptoms?

Someone could have polyps or colorectal cancer and not know it. Colorectal cancer almost always develops from precancerous polyps in the colon or rectum. Screening tests can find polyps so that they can be removed before they turn cancerous.

Screening tests can also find cancer early, when treatment works best. There are several recommended screening tests. Talk to your health care provider about the one that is right for you.

Approximately 60% of deaths from colorectal cancer could be prevented if everyone over age 45 got screened regularly.

Anyone who is 45 years or older should get screened regularly. Once you turn 75, talk to your health care provider to decide whether or not to get screened.

People at higher risk of getting colorectal cancer should get screened earlier than age 45. You may be at higher risk if you’ve previously had colorectal cancer, if an immediate family member has had it, or if you have inflammatory bowel disease. Although rare, some people have genetic markers for inherited forms of colorectal cancer.

Routine screening for colorectal cancer, beginning at age 45, can save lives. Screening tests can find precancerous polyps so they can be removed before they turn into cancer.  Screening tests can also find colorectal cancer early, when treatment works best.

screening tests

There are several approaches to screening. You should talk to your health care provider about which test(s) to choose and how often to use them. The following are some of the more common tests used for colorectal cancer screening:

Fecal Occult Blood Test (FOBT)

Blood in your bowel movement can be detected by an FOBT. There are two types.

1. iFOBT: Uses antibodies to detect blood. If you choose this method, ask your health care provider for an iFOBT or FIT (fecal immunochemical test).
2. gFOBT: uses a chemical called guaiac to detect blood. This method is also called gFOBT. If you choose this method, ask your health care provider for a high sensitivity gFOBT.

Sigmoidoscopy

The health care provider inserts a short, thin, flexible tube to look for polyps or cancer inside the rectum and lower third of the colon.

Colonoscopy

The health care provider inserts a long, thin, flexible tube to look for polyps or cancer inside the rectum and the entire colon. During the test, the doctor can find and remove most polyps and some cancers.

Stool DNA with FIT (sDNA-FIT)

FIT is a test that detects altered DNA in stool.  An entire bowel movement is collected and sent to a lab to be checked for cancer cells. This test does not require bowel preparation, sedation, or transportation to and from a physician’s office. Abnormal sDNA-FIT tests may be followed by a colonoscopy.

abnormal Screening Results

An FOBT test result may be abnormal (positive). Not all positives mean that you have cancer. A follow-up test is required. The follow-up to a positive FOBT test would be a colonoscopy. If the health care provider finds an abnormality during the colonoscopy, he or she may remove polyps or cancer, and decide whether to do further diagnostic tests or treatments.

If a sigmoidoscopy result is abnormal, your doctor will discuss the follow-up procedure options with you.

If your health care provider finds an abnormality during a colonoscopy, he or she may remove polyps or cancer during the procedure. Your health care provider will discuss with you whether further diagnostic tests or treatments are  necessary afterward the procedure.

You may be at increased risk if:

• You or a close relative have had colorectal polyps or colorectal cancer
• You have inflammatory bowel disease, Chrohn’s disease, or ulcerative colitis
• You have a genetic syndrome such as familial adenomatous polyposis (FAP) or hereditary non-polyposis colorectal cancer (Lynch syndrome)

People at increased risk for colorectal cancer may need earlier or more frequent tests. If you think you may be at increased risk, talk to your health care provider about the routine screening tests that are right for you.

The Colorectal Cancer Control Program’s purpose is to increase colorectal cancer screening rates among persons 45-75 years of age by implementing evidence-based interventions and other strategies in partnership with health systems to institute organized screening programs.

Evidence Based Interventions

Reducing Structural Barriers
Structural barriers are non-economic burdens or obstacles that make it difficult for people to access cancer screening (e.g., inconvenient clinic hours).

Provider Assessment and Feedback
Provider assessment and feedback interventions evaluate provider performance in delivering or offering screening to clients (assessment) and present providers with information about their performance in providing screening services (feedback).

Provider Reminders
Reminders inform health care providers it is time for a client’s cancer screening test (called a “reminder”) or that a client is overdue for screening (called a “recall”).

Client Reminders
Client reminders are written (letter, postcard, e-mail) or telephone messages (including automated messages) advising people that they are due for screening. These interventions can be untailored to reach the overall target population or tailored with the intent to reach one specific person, based on characteristics unique to that person, related to the outcome of interest, and derived from an individual assessment.

Guidelines

• U.S. Preventive Services Task Force
• Guide to Community Preventive Services
• Research-tested Intervention Program(s)

Educational and Support Services

American Cancer Society has health professionals that are available 24 hours a day to provide information to cancer patients and their families.

Colon Cancer Alliance provides education on colorectal cancer screening also support and education for those diagnosed with colorectal cancer. They can make referrals for financial support for those diagnosed.

C3 Colorectal Cancer Coalition has information on resources for diagnosis and treatment of colorectal cancer, coping with the emotional and financial stresses of cancer, and facing life as a colorectal cancer survivor.

Lance Armstrong Foundation provides free, confidential, one-on-one support to anyone affected by cancer. This includes those who have cancer or are a loved one, friend, health care professional, or caregiver of someone diagnosed.

211 provides local referrals and information on services available in your community.