Colon Cancer: When & Why You Should Start Screening

Author: Guy Orangio, MD, FACS, FASCRS, University Medical Center Colorectal Cancer Surgeon

Colorectal cancer is the fourth most commonly occurring cancer and the second leading cause of cancer deaths in the United States, with over 56,000 people expected to die from this disease each year. However, this cancer is preventable and curable when detected and treated early.

March is Colorectal Cancer Awareness Month, a perfect time to learn more about this disease and when and why to get screened. Because there are often no symptoms when it is first developing, colorectal cancer can only be caught early through regular screening.

Most colon cancers start as non-cancerous growths called polyps. If we are able to find these polyps while they are still non-cancerous, we remove them and cancer may be prevented. Major surgery can usually be avoided.

Screening programs begin by classification of risk based on personal, family and medical history. People who are at increased risk may need earlier and more frequent screening depending upon the recommendation of their healthcare provider.

The American Society of Colon and Rectal Surgeons (ASCRS), which is dedicated to advancing the treatment of patients with diseases affecting the colon, rectum and anus, supports the following colorectal cancer screening guidelines:

Recommendations Screening People at Average Risk

• Men and women at average risk should have screening for colorectal cancer and adenomatous polyps beginning at age 50 years.
• A colonoscopy (a test that allows the physician to look directly at the lining of the entire colon and rectum) every 10 years or a barium enema (x-ray of the colon) every 5 to 10 years are acceptable alternatives. •

Recommendations for Screening People at Increased Risk

• People at increased risk of colorectal cancer or adenomatous polyps include those with first-degree relatives (parent, sibling, or child) with colon cancer or adenomatous polyps diagnosed before 60 years
• People with two first-degree relatives who were diagnosed at any age, should have screening colonoscopy starting at age 40 years — or ten years younger than the earliest diagnosis in their family — and then repeat every five years.
• People with a first-degree relative with colon cancer or adenomatous polyp diagnosed at age greater than 60 years or two-second degree relatives with colorectal cancer should be advised to be screened as average risk persons beginning at age 40 years
• People with one second-degree relative (grandparent, aunt or uncle) or a third-degree relative (great-grandparent or cousin) with colorectal cancer should be screened as average risk persons

Prevention Tips

In addition to timely and regular screening for colorectal cancer, people may be able to lower their risk of getting the disease by:

• Avoid foods that are high in fat.
• Eating plenty of vegetables, fruits, and other high-fiber foods.
• Exercising regularly and maintaining normal body weight.
• Not smoking and drinking alcohol only in moderation.

For information on the Comprehensive Colorectal Cancer Program at University Medical Center, click here.

About Dr. Orangio

Guy Orangio, MD, is a board-certified colorectal surgeon at University Medical Center and an Association Professor of Clinical Surgery at LSU Health New Orleans.