Colorectal cancer, also called colon cancer, is cancer that develops in the colon or rectum. It is the second-leading cause of death from cancer in the United States.
Nationwide, Kentucky has the seventh-highest incidence of colon cancer and the fifth-highest colon cancer mortality rate. The good news is that colorectal cancer can be prevented.
The risk for colorectal cancer is equal in both men and women and occurs most often after the age of 50. You are at a higher risk for colorectal cancer if you have a first-degree relative — your mother, father, brother, or sister — who has had a polyp or colorectal cancer. Other factors that make your risk higher are having inflammatory bowel disease, Crohn’s disease or ulcerative colitis or having a genetic syndrome that causes polyp growth.
Colorectal cancer usually begins from precancerous polyps, which are abnormal growths. Polyps and early colon cancer rarely cause symptoms. Persistent abdominal pain, unexplained weight loss, or blood in your stool are all possible symptoms. Over time, some polyps can turn to cancer.
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Several screening tests can help detect early colon cancer. These tests include stool tests that check for small amounts of blood in the stool.
At present, there are two types of these tests and include high-sensitivity fecal occult blood tests and fecal immunochemical test. Another stool test is a DNA test (Cologuard®) that identifies DNA biomarkers and genes that have been found in colorectal cancer and advanced precancerous polyps.
These tests require no cleansing of the colon and are low cost, but do not detect all colon cancers and are even more likely to miss polyps. They can give false positive results, and can require additional procedures, such as a colonoscopy.
The gold standard of screening for colorectal cancer is a colonoscopy. It is the most sensitive test to detect colon cancer and polyps and allows visualization of the entire colon and rectum.
More importantly, it also allows for polyps to be removed and biopsies to be taken if necessary. This test does require cleansing of the colon. It is commonly performed with sedation or anesthesia to minimize or eliminate any discomfort.
Colorectal cancer screening tests should be covered by your health insurance without a co-pay or deductible. If you are 50 years old or older talk to your doctor about getting screened.
Dr. Alberto Castellanos, a gastroenterologist with Bluegrass Surgery and Gastroenterology Associates, practices at Baptist Health Lexington.