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Screening for Colorectal Cancer
By Nellie Grose, M.D., M.P.H.
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By Nellie Grose, M.D., M.P.H.
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Health News.  

Screening for Colorectal Cancer

Colorectal cancer (CRC) is the second leading cause of cancer deaths in the US. It is a cancer most often found after the fifth decade of life. It can present earlier when you have a family history of familial polyps or hereditary nonpolyposis colon cancer. As such, doctors recommend screening at age 50 and help you choose from the different screening methods depending on your risks.

You are considered at average risk if you have no symptoms suggesting CRC, no personal history of CRC, colon polyps or inflammatory bowel disease, and no family history of CRC, polyps or familial polyps.

How does my family history affect my colorectal cancer risk?

Family Setting

Approximate Lifetime Risk of CRC

General US population

5 %

One first-degree relative with CRC

2- to 3-fold increase

Two first -degree relatives with CRC

3- to 4-fold increase

First-degree relative with CRC diagnosed
before age 50

3- to 4-fold increase

One second- or third-degree relative with

approximately 1.5-fold increase

Two second-degree relatives with CRC

approximately 2- to 3-fold increase

One first-degree relative with an
adenomatous polyp

approximately 2-fold increase

What are your choices among the various screening methods?
1. Fecal occult blood test (FOBT). You take home three cards to test for blood in your stools. Do this two times a year, every year. The value in the test is in the consistency of testing year after year.
2. Air contrast barium enema (ACBE). This is a radiological exam recommended to be done every five years.
3. Colonoscopy. This is recommended every ten years if no new risk factors develop. It may be of interest for you to know that the gastroenterologist can miss picking up lesions; it can depend on how quickly he or she pulls out the scope. Thus, when you are having the procedure done, make a request to have it done slowly.
4. Virtual colonoscopy. This less invasive technology is gaining respect as a screening tool. From a cost perspective, it is more affordable than a colonoscopy.

In many instances, cost may be the determining factor in your choice, and certainly, any screening is better than no screening.

What about the increased risk group?
Basically, you should be screened at an earlier age and /or have more frequent colonoscopies if you are at a higher risk. It is individually determined depending upon your own history and family history.

Besides screening tests, what can I do to reduce my risk?
Maintaining good bowel health is a great start. Join us Wednesday, Sept. 19, 12:15 to 1:30 pm, for the upcoming seminar “Boosting Your Immune System Naturally,” which will address your bowel health.