Most cancers don’t come with advance warning, but colorectal cancer often does, making most cases preventable with early detection. As the third most common cancer and the second leading cause of cancer death among Americans, colorectal cancer is a disease for which all adults 50 and older should be tested. March has been designated National Colorectal Cancer Awareness Month to highlight important facts about how to help keep yourself safe from this largely preventable disease.
Most colorectal cancers are preceded by growths in the colon called adenomatous polyps. While most polyps are benign, adenomatous polyps result in the majority of colorectal cancers. When caught early, these polyps can be removed before they become cancerous. So why is there such an alarming fatality rate for this highly avoidable cancer? Because many people don’t want to undergo screening, which has a reputation for being somewhat arduous and unpleasant. Let’s review the facts about screening options.
Tests for Colorectal Cancer
Fecal Occult Blood Testing – Patients who are considered at average risk can take advantage of this simple, noninvasive test from the privacy and convenience of home. Once a year from age 50 onward, the patient is mailed a specialized testing kit that allows him/her to collect and mail in a small stool sample for testing for the presence of blood. It has its limitations, however, because many adenomatous polyps don’t bleed and cancer cells may bleed only sporadically. Also, FOBT may produce false positive results if blood is in the stool for other reasons, so supplementary testing is recommended. This test may be combined with a DNA test to identify abnormalities.
Flexible Sigmoidoscopy – The board certified radiologists of Radiology Associates Imaging and the American Cancer Society recommend that average-risk patients also have a flexible sigmoidoscopy every five years to compensate for limits in fecal occult blood testing. In this test, a flexible lighted instrument called a sigmoidoscope is introduced into the colon, enabling the examination of the lower half, to catch polyps early and detect most cases of advanced colorectal neoplasia.
Air-Contrast Barium Enema Examination – Also recommended every five years in conjunction with other exams is the double-contrast barium enema examination, which can discover colon cancer with tremendous accuracy. In this test, a barium solution, usually accompanied by air, is inserted into the colon, so that x-rays may be taken of the entire colon and rectum. It is superior at cancer detection than most other tests, but may miss smaller precancerous polyps.
Colonoscopy – Colonoscopy is considered to be the most effective overall screening test for colon cancer, but it is avoided by many patients because it is invasive, time-consuming and requires patient sedation to perform. Luckily, average-risk patients need to undergo a colonoscopy only every 10 years. Higher risk patients may need screening more often. While no one wants to go through this test, its importance in the early detection of cancer cannot be ignored. Some discomfort is a small thing when compared to the prospect of saving your life.
CT Colonography – The radiologists of Radiology Associates Imaging also offer the newest procedure in colorectal cancer screening, computed tomography colonography, or CTC. Using helical CT information in conjunction with sophisticated software, the CTC exam creates live, highly-detailed, multidimensional images of the colon and rectum, offering vantages comparable to traditional colonoscopy, with less risk and discomfort, and without the need for sedation. As with regular colonoscopy, the patient must undergo a colon cleansing protocol starting the day before.
During a CTC, a small tube is inserted a few inches into the colon and gently inflated with carbon dioxide or air to expand the area. The patient lies still for a few seconds while the CT scanner captures a series of images and sends them to a computer for detailed examination. Studies suggest that for high-risk or symptomatic patients, CTC imaging is comparable to traditional colonoscopy. CTC testing and analysis requires specialized training, and the qualified radiologists and technologists of Radiology Associates Imaging have undergone this additional training for added safety and accuracy.
What Factors Place Someone at Higher Risk?
People at an elevated risk for colorectal cancer include those age 60 and older, those with a personal history of colorectal or certain other cancers and/or a family history of colorectal cancer or polyps, patients with ulcerative colitis or Crohn’s disease, and those of African or Eastern European ancestry. If you have a history of smoking, heavy alcohol use or a high-fat, low-fiber diet, ask your doctor if this elevates your risk. If your doctor has determined that you are at higher risk for colorectal cancer, ask him or her about when to begin diagnostic screening, as it may be recommended that you begin before age 50 and that you receive specific exams.
When it comes to colorectal cancer, prevention is the best medicine, so don’t put it off. For the latest in diagnostic services and the advanced training and dedication of experienced radiologists, you can trust Radiology Associates Imaging for a complete circle of care.