Colorectal cancer is one of the most common types of cancer affecting both men and women worldwide. It begins in the large intestine or rectum and often starts as benign growths known as polyps, which can gradually develop into cancerous tumors. While it is highly treatable when detected early, the challenge lies in identifying it before symptoms appear. This is why regular screening, including tests such as colonoscopies, are critical for early detection and prevention.
The colon is also known as the large bowel or large intestine of the digestive system – it absorbs water and salts from food and helps in forming and storing waste. The rectum is the last segment of the large intestine, where the waste is stored before being expelled from the body. When abnormal growths (polyps) form in these areas, they can sometimes turn cancerous.
While colon cancer can affect anyone, it is most common in people over the age of 50. It is a leading cause of cancer-related deaths, yet it is also one of the most preventable cancers. Many of the deaths associated with this disease could be avoided if individuals followed recommended screening guidelines, allowing for early detection and the potential for complete treatment.
Screening for these types of cancers is crucial because the disease often develops without obvious symptoms in its early stages. By the time symptoms such as blood in the stool, unexplained weight loss, or abdominal pain appear, the cancer may have already spread to other organs, making it harder to treat. Regular screening allows doctors to detect cancer in its earliest, most treatable stages, or even before it develops into cancer at all.
Early-stage colorectal cancer often does not cause noticeable symptoms, which is why screening is vital for identifying it before it progresses. In the early stages, treatment options are more effective, and the prognosis is much better. When cancer is detected early, the five-year survival rate is significantly higher. On the other hand, when diagnosed after symptoms appear, the survival rate decreases due to the potential spreading to other organs or tissues.
One of the key advantages of screening is the ability to identify and remove abnormal growths before they have the chance to become cancerous. Polyps are typically non-cancerous, but some can develop into cancer if left untreated over time. By screening regularly, healthcare providers can detect these polyps and remove them at the time of screening. This makes preventive testing an essential measure that can save lives by halting the cancerous process before it begins.
In addition to detecting potential cancers, regular screenings can also help identify other gastrointestinal issues or risk factors that may predispose an individual to developing cancer. Testing can help gastroenterologists monitor these individuals more closely, potentially catching problems before they become a more serious issue.
The American Cancer Society (ACS) and other health organizations recommend regular screening for individuals of average risk starting at the age of 45. However, those with a family history or other risk factors may need to start screening earlier. The frequency of screening depends on the method used and the individual’s personal health history.
There are several methods available to screen for colon cancer, each with its advantages and considerations.
Stool-based tests are non-invasive options that involve examining a sample of stool to detect cancer-related symptoms or abnormal growths. One of the most common stool-based tests is the fecal immunochemical test (FIT), which detects hidden blood in the stool. The test is simple, can be done at home, and should be repeated annually. However, stool-based tests are not as thorough as other screening methods and may need to be followed up with more definitive testing if results are positive.
Another stool-based test is the fecal occult blood test (FOBT), which looks for hidden blood in the stool that could indicate cancer. Like the FIT test, it is less invasive and can be done at home, but it is also less accurate in detecting colon cancer.
Imaging tests are designed to visualize the colon and rectum, providing detailed images that help identify abnormalities such as polyps or tumors. The most common imaging test is a virtual colonography, also known as a CT colonography. This test uses CT scans to create detailed images of the colon and rectum. It is a non-invasive procedure, and while it can detect abnormalities, it may require further testing if any issues are identified.
Another imaging test is a barium enema, which involves filling the colon with a contrast material called barium to help highlight abnormal growths on X-rays. Although it can detect some signs of colon cancer, it has become less common with the advent of more advanced imaging techniques.
Endoscopic tests are considered the most thorough screening methods because they allow doctors to directly examine the inside of the colon and rectum and remove polyps at the time of the examination. The procedure involves using a flexible tube with a camera (known as an endoscope) to look for abnormalities.
An endoscopic procedure known as flexible sigmoidoscopy examines only the lower part of the colon. The procedure is typically done under mild sedation and allows healthcare providers to both detect and remove polyps in a single visit. Despite the name, the process doesn’t involve the use of a colonoscope but can be just as effective for screening.
While cancer can affect anyone, certain factors can increase an individual's risk of developing the disease. Those with a family history of colon cancer, particularly a first-degree relative who was diagnosed at an early age, should begin screening earlier and may require more frequent checkups. People with inflammatory bowel diseases, a history of polyps, or certain genetic syndromes like Lynch syndrome or familial adenomatous polyposis (FAP) are also at an elevated risk.
By detecting cancer early or preventing it altogether, reduces the risk of cancer-related death and allows for more effective and less invasive treatments. Prevention is a cost-effective and life-saving measure, as early detection saves on healthcare costs and improves quality of life.
Despite the clear benefits, many individuals fail to undergo recommended testing due to various barriers. Some people are unaware of the importance of screening or are hesitant to undergo procedures due to fear, embarrassment, or misconceptions. Others may face financial or logistical barriers, such as lack of insurance or access to healthcare facilities.
Education and awareness campaigns play a critical role in overcoming these barriers, helping individuals understand the importance of screening and encouraging them to take proactive steps toward protecting their health. Healthcare providers must also continue to emphasize the importance of screening to their patients, ensuring they receive the care and guidance needed to make informed decisions about their health.
Preventative testing is essential in the fight against one of the most common and preventable types of cancer. Regular screenings can detect colon cancer early, when it is most treatable, and can even prevent the disease by identifying and removing abnormal growths before they become cancerous. By following recommended screening guidelines and addressing risk factors, individuals can reduce their risk and significantly improve their chances of living a healthy, cancer-free life. Regular screening saves lives and taking that first step could make all the difference in the outcome.
