March is Colorectal Cancer Awareness Month!

What is Colon Cancer? When (and How) Should I Start Getting Screened?

Colorectal cancer - which is often just called “colon cancer” - is a type of cancer that develops when cells in the lining of the colon or rectum begin to grow out of control without stopping. It’s very treatable when caught in its early stages. Unfortunately, as many as one out of three adults choose to forego recommended preventative screening. There are a number of screening tests available for colon cancer, but the colonoscopy exam is the most effective test for both prevention and early detection. Many people might feel scared by the idea of getting a colonoscopy, or may feel that they don’t have time to schedule the procedure. Though the screening process can be intimidating, it’s a very important preventive measure.

With National Colorectal Cancer Awareness Month around the corner, it’s a great time to talk to your doctor about when you should start getting screened for colon cancer. The earlier it’s caught, the greater your chances are of beating it.

How Does Colon Cancer Develop?

The colon, which is also called the large intestine, is a portion of the digestive tract whose function is to absorb water left over from the digestive process in the small intestine. Most of the time, colon and rectal cancers start as small, abnormal growths of tissue called polyps. Over time, some of these polyps can develop into colon or rectal cancer.

If left untreated, or if not caught early on, colon cancer can metastasize (spread to other parts of the body), which makes it significantly more dangerous and harder to treat. Colon polyps can actually be removed during a colonoscopy, which means that regularly-scheduled colonoscopies can actually help prevent colon cancer.

Who’s at Risk of Developing Colorectal Cancer?

Colon cancer is the second leading cause of death among cancers that affect both men and women. Each year, roughly 140,000 new cases of colorectal cancer are diagnosed in the US and approximately 50,000 people die from the disease.

Scientists do not currently know why colon cancer develops, but research has shown that certain factors may increase a person’s risk. Age is the number one risk factor for developing colon cancer - over 90% of diagnoses are given to individuals of age 50 years or older.

Additional risk factors associated with colorectal cancer include:

• Ethnicity (individuals of African American or Ashkenazi Jewish descent are more likely to develop colorectal cancer)
• Inherited genetic mutations (passed down from the mother and/or father)
• Acquired genetic mutations (random mutations of genes that were not inherited)
• Having type 2 diabetes

Certain lifestyle habits may also contribute to an individual’s risk of developing colon cancer. Your risk may be higher if you:

• Eat a diet that is heavy in packaged or fatty foods, and low in fruits, vegetables, and fiber
• Use tobacco products
• Consume alcohol moderately or heavily
• Are overweight or obese
• Don’t exercise or aren’t physically active

These symptoms often don’t appear until the disease is in its later stages, and they may also be easily mistaken for a less serious condition, like irritable bowel syndrome (IBS). This is one of the reasons that it’s so important to get screened regularly - there may be no other way to learn whether you have colon cancer.

If you’ve noticed any of these symptoms, especially blood in the stool or a prolonged change in bowel habits, make an appointment to see your gastroenterologist right away. Finding colon cancer early on, before it spreads to other parts of the body, increases the likelihood of survival.

Who Should Be Screened for Colorectal Cancer, and When?

If you have one or more of the main risk factors associated with colon cancer (listed above), you may be considered to be at an increased risk and should start screenings at the age of 45. You’ll repeat screenings at regular intervals, to be determined by your doctor.

If you don’t have any of the risk factors listed above, you’re likely at an average risk of developing colorectal cancer and will most likely be advised to begin screening at 50 years old. No matter your risk level, talk to your doctor about when you should begin colon cancer screening, and how often you should be screened.

Unless a patient has other medical problems that would prevent them from getting screened everyone should be in some type of colon cancer screening program. The recommendations to start screening is actually in a state of evolution. The guidelines for patients of average risk use to recommend starting at age 50. Recent studies have shown a dramatic rise in the incidence of colorectal cancer in younger patients- ages 20 through 40. The exact reason for this is unclear. Very recently the American Cancer Society dropped their recommended screening age to 45 to try and capture some of these younger patients. Unfortunately, most insurance plans have been slow to adapt to these recommendations. Patients with a first-degree family history of colon cancer should start 10 years earlier than the age of the family member with colon cancer. Talk to your doctor about the timing of your screening colonoscopy. If you are having any of the above symptoms see your doctor immediately.

Does Insurance Pay for Colorectal Cancer Screening?

Patient and provider reimbursement for colon cancer screening depends on your particular insurance plan. Patients who receive health coverage under Medicare or the Affordable Care Act may be eligible for full colorectal cancer screening, including colonoscopy. Call your insurance provider to learn whether you’re covered for colorectal cancer screening.

Talk to Your Gastroenterologist About Colorectal Cancer

If you’re concerned that you’re experiencing symptoms of colorectal cancer, make an appointment to see your gastroenterologist right away. When detected early on, colorectal cancer is usually very survivable. Talk to your doctor about which screening options are best for you based on your family history, your current health, and age.