March 7, 2019
“In 2018, colon cancer was the third most common cancer in both men and women, says David T. Walsworth, MD, clinic director for MSU Family Health Center who has been treating patients for 26 years. “Each man has a 1 in 22 (4.49%) and woman has a 1 in 24 (4.15%) lifetime risk of colon cancer.”
According to the CDC’s National Center for Health Statistics most recent data, 69.6% of Michigan adults 50-75 years of age are following medical guidelines and getting colorectal screenings. It has increased slightly from 2012 to 2016 but is still behind the 80 percent screening goal stated in the federal government’s national screening agenda — Healthy People 2020.
So why are adults skipping their screenings?
“There are many reasons, some may not be aware that there are multiple ways to screen, including testing a stool sample for blood that you cannot see," The test, called a fecal immunochemical test (FIT) can often be done in the privacy of your home. Walsworth goes on to explain, "They may not like the prep needed for colonoscopy or the thought of getting a stool sample for occult blood screening.”
Is a screening difficult? Not according to Walsworth.
“A simple stool sample done every year, or a short procedure under sedation following a thorough bowel prep done, generally, every 3-10 years may find a cancer before it becomes advanced, and harder to treat.”
Your risk factors determine which colorectal screening is right for you
The United States Preventive Services Task Force recommends adults start yearly colorectal screening at age 50 years and continue through age 75 years. USPSTF recommendations are based on a rigorous review of existing peer-reviewed evidence. The task force lists several screening options to meet the recommendation. From stool tests, to colonoscopy or Multi-targeted stool DNA testing, CT colonography and flexible sigmoidoscopy, the list and descriptions of screening tests can be overwhelming for the uninitiated.
According to Walsworth, “If you have a personal history of polyps, a family history of colon cancer, or have had a positive FIT test, you should have a colonoscopy so that any polyps can be biopsied to learn how abnormal they are. If none of these apply, a FIT test or a colonoscopy could be appropriate.”
Ask your provider what is right for you
The USPSTF doesn’t recommend one test over another. The guidelines help primary care clinicians and patients decide together whether a preventive service is right for a patient’s needs. So, the best way to decide is at the advice of your clinician. If you are at a high-risk for colon cancer, Walsworth recommends patients “ask their provider about a referral for a colonoscopy.”
Risk factors for colon cancer
Reducing your risks in addition to getting the recommended screening can help avoid getting colorectal cancer. The following are colorectal cancer risk factors according to the Centers for Disease Control.
Risk Factors for colorectal cancer:
Lifestyle factors that may increase your risk of colorectal cancer:
If you are between the ages 50 and 75, or have any of the risk factors for colorectal cancer, talk with your doctor about a colorectal screening today.
David Walsworth, MD, is a family medicine doctor who provides primary care to the public in MSU Family Health Center. Visit his provider page to learn more about his clinical care or visit the MSU Family Health Center site to become a new patient.
*Source: Joseph DA, King JB, Richards TB, Thomas CC, Richardson LC. Use of colorectal cancer screening tests by state. Preventing Chronic Disease 2018;15:170535.