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Prevention and Screening of Colon and Rectal Cancer

Sanjay S. Reddy, MD, FACS believes the physician-patient relationship is one of the foundations to building a plan to treat cancer, and offers guidance through each stage of treatment. Sanjay S. Reddy, MD, FACS believes the physician-patient relationship is one of the foundations to building a plan to treat cancer, and offers guidance through each stage of treatment.

If the thought of undergoing a colorectal cancer screening makes you a little uncomfortable you’re not alone. But this one day of minor discomfort can save your life.

Preventative healthcare for colorectal cancer is vital to your wellbeing. Preventative healthcare means knowing the risk factors, signs, and symptoms — and undergoing a screening that can help your physician detect early signs of the disease.

Early detection through screening has helped the colorectal cancer death rate drop over the past several decades. Thanks to the increase in preventative healthcare, as well as advances in treatment options, the 5-year survival rate is 90% when colorectal cancer is found before it has spread.

In many cases, screening can detect colorectal cancer early — and even prevent it entirely.  A polyp — or a growth of tissue — in the colon can take several years to develop into cancer. If found early enough, polyps can be removed before they develop into cancer. Even when the polyp has become cancerous, if detected early enough with regular screening, your chance of surviving colon cancer is high. 

Despite this good news, there are still millions of people who are not getting screened as they should be. Most new cases of colorectal cancer occur in people 50 years and older, but less than half of people ages 50 to 54 are up to date with their screenings.

Why Choose Fox Chase?

At Fox Chase, we offer comprehensive services for colorectal cancer, from screening and prevention, diagnosis, and cancer risk assessment to treatment and survivorship care. We can treat colon cancer and we can also help you prevent it. Our team of specialists from different disciplines work together to provide you with the best care possible.

Our skilled gastroenterologists use colonoscopies and other screening tools to find polyps. We also offer innovative tools — such as virtual colonoscopy — as well as less invasive screening approaches — such as stool DNA or stool occult blood tests — when a traditional colonoscopy is not an option. If something abnormal is found, we will spend time with you and your family to ensure that you are fully engaged in the planning for the next steps.

Colorectal Cancer Screening Tools and Guidelines

Most guidelines recommend starting average-risk colon cancer screening for most people at age 50. For people of African ancestry, average-risk colon cancer screening starts at age 45. Recently, the American Cancer Society recommends starting average-risk screening for everyone at age 45. Be sure to check with your doctors and insurance to see at what age your coverage begins.

At Fox Chase, we can perform several different types of colorectal cancer screenings, including:

  • Colonoscopy: A colonoscopy is a procedure that allows your physicians to look inside your intestine while you are asleep. They do this by inserting a small flexible tube, equipped with a tiny camera and light, into your entire colon to look for any abnormalities. The risks associated with this exam are very low. This test is typically done every 10 years if your results are normal, or every 3 to 5 years if there are polyps.
  • Virtual colonoscopy: Also called computerized tomography (CT) colonography, this screening procedure uses very low-dose radiation to create images of your entire colon from outside of your body while you are awake. This test is like a normal CT scan, but designed especially for your colon. It can see other parts of your abdomen as well. This test is done every 3 years with normal test results. If the test is abnormal, indicating the presence of polyps or tumor, then you will need to undergo a colonoscopy.
  • Sigmoidoscopy: A sigmoidoscopy is a procedure that allows your physicians to look inside the rectum and left colon for polyps and other signs of cancer. A thin, shorter, flexible tube with a camera and light is inserted into the rectum and advanced only to the left colon. Small polyps or tissue samples might be taken for further testing during this procedure if needed. You can choose to be either awake or asleep for this exam.
  • Stool DNA test: A stool DNA test examines your stool sample for any DNA material that might be shed by an occult colon cancer. This test is done in the privacy of your home and then mailed to the indicated testing center. This test is done every 3 years with normal test results. If this test indicates anything abnormal, you will need to undergo a colonoscopy.
  • Fecal occult blood test: A fecal occult blood test (FOBT) is a test you can do at home or in your doctor’s office to check your stool for blood. Blood in the stool can be a sign of polyps or cancer present in the colon. There are two types of FOBTs, both of which require that you provide a stool sample for testing. If the test comes back positive, you will need to undergo a colonoscopy. The two types of FOBTs are:
    • Fecal immunochemical test (FIT): Also called an immunochemical FOBT, this test requires you to mix a small sample of your stool into a solution. It can be tested at home or mailed to a testing center. It is a better test in detecting colon cancer and a little bit more expensive.
    • Guaiac FOBT: A guaiac FOBT involves putting a very small sample of stool directly on a card and testing it with a special solution to detect the presence of blood. You can do it at home or in the doctor’s office. If you do it at home, the cards will be mailed to your doctor’s office for further testing.

Risk Factors for Colorectal Cancer

Age is a strong risk factor for colorectal cancer. Though young people can get colon cancer, your risk increases as you get older. It is much more common among people over 50 years old.

If you’ve had close family members — like a parent, sibling, or child — who have had polyps or colon cancer, you are at a higher risk of developing colorectal cancer. If you’ve had multiple family members with colorectal cancer — especially on one side of the family — it may mean that colorectal cancer is hereditary in your family.

At Fox Chase, we offer gastrointestinal cancer risk assessments. One type of risk assessment is to test for inherited colon cancer syndromes such as Lynch syndrome or familial adenomatous polyposis (FAP). Your doctors and genetic counselors will help determine if you might benefit from cancer genetic testing.

Other colorectal cancer risk factors include having chronic inflammatory bowel disease (IBD), a history of receiving pelvic radiation, or a history of having other cancers. A history of having certain types of polyps in your colon can also lead to a higher risk.

While knowing the risk factors is an important first step, it’s possible to get colorectal cancer without having any of them. Knowing your body is key — any changes in bowel habits, unexplained abdominal pain or rectal bleeding should be checked by your physician. In addition, you should undergo colorectal screening when you reach the recommended age, even if you do not have any symptoms.

Preparing for your Colonoscopy: Tips from the Experts at Fox Chase

While colonoscopy is a vital tool to help your physician find any signs of cancer, many people put them off because of fear of the preparation, which includes a clear liquid diet and a special drink to clear your bowels the day before.

7 Tips to Make the Colonoscopy Prep Process Easier

  1. Don’t drink the prep all at once. Instead, split the drink as instructed. Drink the second half of it closer to the time of the procedure for a cleaner colon and more accurate screening.
  2. Slow down. Drink the prep slowly — there’s no need to rush through it.
  3. Stay near the bathroom. The purpose of the drink is to make you use it.
  4. Stay hydrated. Drink liquids high in electrolytes, rather than just coffee and tea.
  5. Drink it all. The prep drink helps with the screening process, so consuming the entire drink is important.
  6. Know your body. If you sometimes experience constipation, take something to help de-constipate several days before prep.
  7. Remember: it’s worth it. If you’re at an average risk, you only have to have a colonoscopy once every 5 to 10 years. And screening saves lives.

Q&A About Colonoscopies

Q: Will getting a colonoscopy hurt?
A: Most people don’t feel any pain during a colonoscopy. However, you may feel mild cramping or bloating afterward because air was puffed into the colon to allow your physician to examine you thoroughly.

Q: Will I be asleep during the test?
A: Normally, you will be asleep with the assistance of a team of anesthesia professionals.

Q: What happens during a colonoscopy?
A: Your physician will insert a small, flexible scope with a light and a camera on its end into the rectum and guide it up to the other end of the colon. Small amounts of air will be released into the colon to allow viewing of the area and pictures to be taken. If your physicians see abnormal tissues or polyps, they will remove them or take small samples at that time.

Q: How long does it take?
A: The procedure itself takes about 30 minutes. Because of the medicine you are given, though, you will not be able to drive yourself home. You must arrange for a ride home after and plan to stay home until the medicine wears off.

Q: What if my physicians find something?
A: If a small polyp is found during the procedure, your physician will likely remove it during the test. If it’s too large — or you have another abnormality that may be a sign of cancer — your physician will take a small piece of it for further testing. This testing will determine your need for additional procedures or treatment.

Whether you are looking to undergo your first colorectal cancer screening or are seeking a second opinion or more information about a screening you’ve undergone elsewhere, Fox Chase’s GI cancer experts can help.

WHAT TO DO NEXT:

Request an appointment or screening online, or call 888-FOX-CHASE. For general information or to ask us a question, please visit our Contact Us page.

Risk Assessment and Genetic Testing

Fox Chase offers a Risk Assessment Program for individuals and families at risk for cancer and those with cancer—including breast, ovarian, gastrointestinal, endocrine, kidney, diffuse gastric, uterine and skin cancers. Our team of physicians, nurses and genetic counselors provides clinical and genetic evaluation and testing, screening and cancer risk-reduction services. To contact Fox Chase about these programs call 877-627-9684. 

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