Don't Skip Your Colorectal Cancer Screenings

The University of Kentucky Public Relations & Strategic Communications Office provides a weekly health column available for use and reprint by news media. This week's column is by Dr.

Avinash Bhakta, colorectal surgeon at the University of Kentucky Markey Cancer Center.

LEXINGTON, Ky. (Sept. 15, 2020)— With the recent untimely death of actor Chadwick Boseman, colorectal cancer has been in the headlines lately. This disease is a leading cause of cancer death in Kentucky, and it often doesn’t cause symptoms, especially in its early stages.

Recent national recommendations now advise both men and women to begin colorectal cancer screenings at age 45. However, colorectal cancer can develop in younger people – Boseman was only 39 when he was diagnosed – and this is often hereditary.

In Kentucky, a genetic disease caused Lynch syndrome is very common, and it greatly increases your risk of developing colorectal cancer. If you have a family history of colorectal cancer or polyps, you may need to be screened earlier – check with your healthcare provider.

Here are the current options available for screening. Speak with your doctor and insurance company to determine which test works best for you.

Colonoscopy: Colonoscopies are extremely effective at detecting colorectal cancer and precancerous lesions. During this test, doctors will examine the rectum and entire colon using a colonoscope, and they can actually remove any abnormal growths as they find them. This screening requires a complete cleansing (“prep”) of the colon using an oral laxative. Most patients will be under sedation throughout the procedure.

CT colonography: Also known as a virtual colonoscopy, this is a CT scan of the entire colon and rectum. It requires bowel prep, but patients do not need sedation. It is less invasive than a colonoscopy, but is diagnostic only – if polyps are found, patients will need a traditional colonoscopy to remove them.

Sigmoidoscopy: This is very similar to a colonoscopy, but only looks at part of the colon. Most patients do not need sedation, and bowel prep is less extensive than a colonoscopy (two enemas only). If there is an abnormal finding, a full colonoscopy is required.

Fecal occult blood tests (known as gFOBT or FIT tests): This at-home test looks for blood in the stool, which can be a sign of polyps or colorectal cancer. Patients collect their own stool samples using a kit and return the sample to their doctor. Depending on which type of test you are given, there may be dietary restrictions prior to testing.

Stool DNA test (Cologuard): This at-home test checks for blood in the stool and for nine DNA biomarkers in genes that are found in colorectal cancers. Patients collect their own samples using a kit and mail it to a laboratory for testing. This test is more accurate than a gFOBT or FIT test, but is also more likely to result in a false positive. All at-home tests need to be repeated on a yearly basis, and any positive findings will require a follow-up colonoscopy.

Getting regular screenings is important, even with the COVID-19 pandemic keeping many of us at home. Don’t skip your regular check-ups, and if you notice any changes in your bowel habits that last longer than a few days, don’t be afraid to call your healthcare provider to get it checked out.