Q: How important is getting screened for colon cancer?

A: As a gastroenterologist, I spend a great deal of time talking with patients and their families about the importance of colon cancer screening. It is therefore, my pleasure to take this opportunity to discuss colon cancer screening.

Colorectal cancer is the third most common cause of cancer and the second leading cause of death from cancer in the United States. There are endless statistics about colon cancer, but I emphasize just one: 1 out of 22 people will develop colon cancer in their lifetime in the United States. For a cancer that is preventable, I find this lifetime incidence much too high. We can significantly lower the incidence of colon cancer through increased screening.

There are two main screening methods that are supported by the United States Preventative Task Force (USPTF): stool-based tests and direct visualization in the form of colonoscopy. We must recognize that early-stage cancer and colon polyps, which are abnormal growths of the cells lining your colon, often do not cause symptoms. It is for this reason that these screening tests are performed on patients without symptoms. Our goal with screening is to detect and remove polyps before they turn into cancer, or detect cancer early when it can still be cured.

Stool-based testing can be ordered through your primary care physician’s office and works by detecting blood or abnormal cells in the stool. These tests detect changes that you cannot see. These are performed once per year.

The second method of screening is with a colonoscopy. This is a test that uses a high definition camera on a narrow tube and directly examines the colon for polyps or tumors. This is the only test that allows for the removal of pre-cancerous polyps or biopsies. A colonoscopy is the definitive test if a stool-based test returns abnormal. This test is performed every 10 years if no polyps are found.

Screening for colon cancer is recommended for patients between the ages of 50-75. Anyone with a family history of colon cancer or polyps should discuss this with their primary care physician, as screening will often be indicated before age 50. As a gastroenterologist, I screen patients for colon cancer by performing colonoscopies. However, I urge that all patients get screened for colon cancer by either method that they prefer.

Screening for colon cancer is effective and has led to a decline in colon cancer incidence in the United States over the past few years. For a condition that is preventable, there is no reason why we should not continue to see a decline in colon cancer incidence through increased screening rates.  I urge you to speak with your primary care physician to determine if it is time for you to get screened.