Colorectal Cancer Q&A: The Truth about Screening, Prevention, and More

New Milford Hospital
Digestive Track

Summary:

  • A colonoscopy is the best way to screen for and prevent colorectal cancers because it allows your doctor to find and remove precancerous growths called polyps before they have a chance to turn into cancer.
  • The U.S. Preventive Services Task Force (USPSTF) recommends that most people have colonoscopy to screen for colorectal cancers starting at age 50. People who are at a higher risk for colorectal cancers due to family history or other factors should begin having screenings at a younger age based on their doctor’s recommendation.
  • Cologuard, an at-home test, is not a preventive colorectal cancer screening test because it detects cancer after you develop it.

DANBURY, Connecticut, March 6, 2019 — If you’re like most people, you might feel a little uncomfortable talking about colorectal health — even with your doctor. But the truth is that your colon, also called the large intestine, is a critical part of your digestive system that performs the important job of absorbing water and getting rid of waste. And because your colon is so important to your overall health and well-being, one of the best ways to keep your colon healthy is to follow your doctor’s recommendations and have routine colonoscopy exams to screen for colorectal cancers.

At Western Connecticut Medical Group (WCMG), our gastroenterologists have years of experience advising patients about digestive health. In observance of Colorectal Cancer Awareness Month, three of our experts — Steven Brandwein, MD, Gastroenterologist, Joseph Fiorito, MD, FACG, Gastroenterologist and Chief of the Department of Gastroenterology at Danbury Hospital, and Steven Gorelick, MD, Gastroenterologist and Hepatologist and Senior Medical Director for Medical Subspecialty and Oncology at Danbury Hospital— provided answers to common questions many patients have about colorectal cancers, colonoscopies, and at-home colon screening tests.

Q – What are colorectal cancers, and are they preventable?

A – Dr. Brandwein: Colorectal cancers start in the colon or the rectum. These cancers can also be named colon cancer or rectal cancer, depending on where they start. Colorectal cancers occur when cells in your colon or rectum grow out of control. It begins as a growth in the lining of the colon or rectum called a polyp. If left untreated, some polyps can eventually turn into cancer. Colorectal cancers can be prevented by removing polyps before they turn into cancer.

Q – What is a colonoscopy?

A – Dr. Fiorito: Colonoscopy is an outpatient screening exam that allows your doctor to look at the inside lining of your colon and rectum to check for pre-cancerous growths called polyps and other irregularities. Colonoscopy is the only test that can screen for and prevent colorectal cancers because it allows your doctor to find and remove polyps before they have a chance to turn into cancer.

Dr. Fiorito explains how colorectal cancers are preventable in this short video.

While you are under sedation, your doctor will guide a flexible tube called a colonoscope into your anus, through your rectum, and into your colon. The tube has a light and a video camera on the end, which transmits an image to a video monitor that your doctor will use to look at the inside of your colon. If your doctor finds a polyp, he or she can remove it during your colonoscopy.

Q – Who should have a colonoscopy?

A – Dr. Brandwein: According to the U.S. Preventive Services Task Force (USPSTF) — which is the governing body for setting colorectal screening guidelines — people who are at average risk for colorectal cancer should begin having colonoscopies at age 50. People who have a family history of colorectal cancers or other risk factors should begin screenings earlier.

Dr. Brandwein talks about the importance of colonoscopy screenings in this short video.

Risk factors are conditions or habits that make it more likely that you will get a disease like cancer. Some risk factors can be changed and others cannot. Speak with your health care provider if you have any of the following risk factors for colorectal cancers.

Risk factors you cannot change

  • Age: Colorectal cancers are more common in people aged 50 and older, but young adults can also get colorectal cancers. In fact, occurrence of young onset colorectal cancers is on the rise in the United States.
  • Family History: People with first-degree relatives (parent, sibling, or child) who were diagnosed with colon or rectal cancer or had adenomatous polyps (benign tumors) should have colonoscopy screenings starting when they are 40 years old, or 10 years younger than the earliest diagnosis in their family. For example, if your mom was diagnosed with colon cancer at age 45, you should have a colonoscopy screening at age 35.
  • Personal History: If you have inflammatory bowel disease or have had colorectal polyps or colon or rectal cancer your doctor may recommend colonoscopy screenings at an earlier age and more often.

Risk factors you can change

  • Eating an unhealthy diet high in fats, salt, sugar, and processed foods
  • Moderate to heavy alcohol use: According to the Dietary Guidelines for Americans, moderate alcohol consumption is defined as having up to one drink per day for women and up to two drinks per day for men; heavy alcohol use is defined as consuming eight drinks or more per week for women, and 15 drinks or more per week for men
  • Smoking tobacco
  • Unhealthy weight (overweight or obese)

Dr. Fiorito provides tips for how to reduce your risk of developing colorectal cancers in this short video.

Q – Recently, there has been a lot of buzz about Cologuard. What is Cologuard, and is it beneficial?

A – Dr. Fiorito: Cologuard is an FDA-approved, at-home colon cancer screening test that is available by prescription only. Cologuard tests for blood or altered DNA in your stool that could be a sign of colon cancer. Cologuard detects colon cancer after you already have it. A colonoscopy, on the other hand, prevents colon cancer by detecting precancerous polyps, which can be removed during the exam.

A – Dr. Gorelick: We recommend colonoscopy for all of our patients versus Cologuard. The Cologuard test is good for identifying advanced polyps and colon cancer, but it does not pick up polyps that can turn into cancer. This can create a situation where a patient thinks they have a negative screening test, but they actually have a precancerous polyp. There are also issues with false positive tests and insurance coverage.

Hear more about the symptoms of colorectal cancers from Dr. Gorelick in this short video.

Q – Is there anything I can do to reduce my risk of developing colorectal cancers?

A – Dr. Gorelick: The best thing you can do to prevent colorectal cancers from developing is to follow your doctor’s recommendations regarding preventive screenings and lifestyle modifications. Scheduling routine colonoscopies could save your life. Taking care of your overall health by eating a healthy diet, getting regular exercise, maintaining a healthy weight, limiting alcohol, and quitting smoking can also help to lower your risk for colorectal cancers.

We’re here for you! To schedule an appointment with Drs. Brandwein, Fiorito, or Gorelick visit our website or call WCMG Danbury Gastroenterology Specialists at (203) 739-7038.