How And When To Get Screened For Colon Cancer

Colon cancer, also known as colorectal cancer, is a significant health concern and a leading cause of cancer-related deaths worldwide. However, it’s also one of the most preventable forms of cancer when detected early through appropriate screening. Screening tests can identify abnormal growths in the rectum or colon, allowing for their removal before they develop into cancer.  

Furthermore, screening can find colon cancer at an early stage when treatment is most effective. Understanding the guidelines and available options is a critical step in taking control of one’s health. 

Read on to learn how and when to get screened for colon cancer.  

Understanding Colon Cancer and the Importance of Screening 

Colon cancer typically develops from precancerous polyps. These polyps can grow for years and transform into cancer without causing any noticeable symptoms. This silent progression is precisely why screening is so vital as it aims to catch these developments long before symptoms arise. Symptoms often only appear once the cancer has advanced and become more challenging to treat. These can include a persistent shift in bowel habits, persistent abdominal pain, unexplained weight loss problem, rectal bleeding or blood in the stool, and fatigue. 

As such, screening acts as a powerful preventive tool. By finding and removing polyps, a colonoscopy can actually prevent cancer from forming altogether. For those seeking such preventive care in Singapore or wherever they may be, a high-quality colonoscopy Singapore is a cornerstone procedure. Adherence to screening guidelines has been directly responsible for a significant decline in colon cancer incidence and mortality over recent decades. 

General Screening Guidelines: When to Start 

The landscape of screening guidelines has evolved, with most major medical organizations now recommending that individuals at average risk begin screening at age 45. Below are the general screening guidelines to consider:  

Average Risk 

Adults with no personal or strong family history of colon cancer or advanced polyps, no known genetic syndrome, and no history of inflammatory bowel disease (IBD) should begin regular screening at age 45. This includes both men and women. 

Increased Risk 

Individuals with certain risk factors require earlier and more frequent screening. This group includes: 

• Those with a first-degree relative (parent, sibling, or child) who had colon cancer or an advanced polyp diagnosed before age 60; 
• A personal history of colon cancer or certain types of polyps; 
• A personal history of inflammatory bowel disease (Crohn’s disease or ulcerative colitis); 
• A confirmed or suspected hereditary syndrome such as Lynch syndrome or Familial Adenomatous Polyposis (FAP); 
• A history of radiation to the abdomen or pelvis for a prior cancer. 

For those at increased risk, screening often begins at age 40, or 10 years before the youngest diagnosis in a first-degree relative, whichever is earlier. A gastroenterologist can provide personalized guidance based on an individual’s risk profile. 

Types of Screening Tests 

Screening tests are broadly categorized into two groups. The choice of test depends on personal risk, preference, availability, and a doctor’s recommendation. Below are the different types of screening tests:  

Stool-Based Tests 

These tests check for hidden blood or abnormal DNA in the stool, which can indicate cancer or large polyps. The following are some stool-based tests:  

Fecal Immunochemical Test (FIT) 

This test detects hidden blood in the stool. It’s done annually and requires no dietary or medication restrictions beforehand. A positive result requires a follow-up colonoscopy. 

Fecal Occult Blood Test (FOBT) 

Like FIT, the guaiac-based FOBT also detects blood but requires dietary restrictions. It’s also performed annually. 

Multi-Target Stool DNA Test (mt-sDNA) 

This test combines FIT with a test that detects altered DNA in cells shed by precancerous polyps or cancer into the stool. It’s done every three years. A positive result requires a follow-up colonoscopy. 

Visual (Structural) Exams 

These tests allow a physician to directly view the structure of the colon and rectum for abnormalities. Below are some visual exams options:  

Colonoscopy 

This is the most comprehensive screening method. A long, flexible tube with a camera on the end (a colonoscope) is used to examine the entire colon. Any polyps found can be removed during the procedure. If no abnormalities are found and the individual remains at average risk, it’s typically repeated every 10 years. 

CT Colonography (Virtual Colonoscopy) 

This uses computed tomography (CT) scans to produce images of the colon. It requires the same bowel preparation as a standard colonoscopy but does not require sedation. It’s performed every five years. Any polyps or abnormalities found require a follow-up colonoscopy for removal or biopsy. 

Flexible Sigmoidoscopy 

This procedure examines only the lower third of the colon. It’s done every 5 or 10 years, sometimes with annual FIT. A positive finding would require a full colonoscopy. 

Overcoming Barriers to Screening 

Common reasons for avoiding screening include fear of the procedure, anxiety about the preparation, embarrassment, and cost. It’s important to address these concerns openly with a healthcare provider. The prep’s discomfort is short-lived, and the sedation ensures a pain-free procedure.  

The medical team’s professional and respectful nature also mitigates the potential embarrassment. Regarding cost, most insurance plans, including Medicare, can cover preventive care for colon cancer for eligible individuals. 

Final Thoughts 

Colon cancer screening is a powerful and proven preventive measure. By keeping the information mentioned above in mind, individuals can prevent cancer development or detect it at its earliest, most curable stage. Discussing options with a healthcare provider is vital to safeguarding long-term health.