Time for Colon and Rectal Cancer Screening?

You’re approaching your 50th birthday or passed it, you know it’s time to ask your doctor about a colon and rectal cancer screening.

If you’re hesitating or reluctant to be screened, you shouldn’t be. The tests you should have depend on your age and whether you are at greater risk of getting colon cancer because of your personal or family health history.

What’s the importance of being tested for a disease you may not have and never get? The American Cancer Society (ACS) says:

  • Screening methods can quickly detect and remove polyps, which are mushroom-shaped growths on the lining of the colon and rectum, before they become cancerous.
  • The symptoms of colon and rectal cancer (or colorectal), such as hidden blood in your stool, often are not readily apparent. Without a thorough examination, you may never know if you have the disease until it has advanced to other parts of your body.

Recommended screenings

According to ACS, men and women with no known risk factors or symptoms should undergo one of the five screening options beginning at age 50:

  1. A fecal occult blood test (FOBT) every year, or
  2. Flexible sigmoidoscopy every 5 years, or
  3. A fecal occult blood test every year plus flexible sigmoidoscopy every 5 years, or (Of these first 3 options, the combination of FOBT every year and flexible sigmoidoscopy every 5 years is preferable.)
  4. Double-contrast barium enema every 5 years, or
  5. Colonoscopy every 10 years
  1. Fecal occult blood test (annually) and a sigmoidoscopy or colonoscopy (every five years). You can do the fecal occult blood test at home to see if there are invisible amounts of blood in your stool. During a sigmoidoscopy, a 2-foot-long lighted tube is inserted into the lower third of your colon. More than half of all polyps are detected in this area. The test takes about 10 to 20 minutes and is usually done in your doctor’s office without anesthesia.
  1. Barium enema (every five to 10 years). Your large intestine is coated with barium sulfate, then injected with air and X-rayed to locate abnormal growths. The test takes about 30 to 45 minutes. Some experts believe this test should not be done anymore.
  1. Colonoscopy (every five years). This procedure, which takes about 30 minutes, is the most invasive but also the most accurate and is usually performed in a hospital. The doctor probes all 5 feet of your large intestine and rectum with a flexible tube while you are sedated. The tube, which is about as thick as a finger, is equipped with a light and connected to a video display monitor for your doctor to view the inside of your colon. The colposcope also can be used to remove small polyps and stop bleeding. The day before the test, you’ll have to stick to a liquid diet and follow your doctor’s instructions for cleansing your bowel and intestines.
  1. A digital rectal examination should be done at the same time as the sigmoidoscopy, barium enema and colonoscopy.

You should consider a different testing schedule with screening starting at age 40 with more frequent exams starting before 50 if you or someone in your family has had:

  • Benign colon polyps or colorectal cancer.
  • Inflammatory bowel disease, ulcerative colitis, or Crohn’s disease.

Advances in testing

Researchers are developing a virtual colonoscopy, in which an MRI or CT scan is used to make a computer-generated, three-dimensional image of your colon, says Bernard Levin, M.D., vice president for cancer prevention at the University of Texas Anderson Medical Center. “It is potentially very useful,” Levin says. But the test may not be ready for another five years.

Researchers also are trying to perfect a test to find possible gene abnormalities by checking your stool. About 20 percent to 25 percent of colon cancer cases are caused by inherited abnormalities in genes, and so far, researchers have been able to identify the genes involved in 6 percent of the hereditary colon cancer cases, Levin says.

Some studies have shown that people who regularly use aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) have a lower risk of colon cancer, ACS says. Some anti-inflammatory drugs are effective in reducing the size of pre-cancerous polyps.

Prevention guidelines

Besides regular cancer screenings, here are some other tips from ACS and Cancer Research Foundation of America on how you can lower your risk of colon cancer:

  • Eat a low-fat, high fiber diet with five or more servings of fruits and vegetables and 25 grams to 30 grams of fiber daily. Research suggests certain fruits and vegetables, such as oranges, spinach, corn, strawberries, bananas and apples, contain antioxidants that reduce the risk of cancer by preventing cell damage from free radicals, which are unstable compounds produced by ordinary biological processes in the body. Whole grain breads, cereals, nuts and beans are good sources of fiber.
  • Eat foods with folic acid, a cancer-fighting B vitamin found in multiple vitamin supplements, and foods rich in foliate, such as fortified breakfast cereals, enriched bread, rice, pasta, fruit juices, green vegetables and beans. You’ll want to take a multivitamin supplement, since you’ll get only half of your daily recommended amount of folic acid (400 micrograms) from the foods you eat.
  • Add calcium to your diet. Calcium may help by regulating cell overgrowth. Get at least 1,200 to 2,000 milligrams of calcium a day whether through foods or pills.
  • Reduce intake of red meat such as pork, beef and lamb. Eat these foods only two to three times a month. A study of women found they had two and a half times the normal risk of colon cancer when red meat is eaten daily.
  • Drink alcohol only in moderation and don’t smoke.
  • Exercise at least 20 to 30 minutes three or four days a week.