Although the vast majority of colorectal cancer - often called colon cancer - occurs in people age 50 or older, it can happen at any age. Colorectal cancer is the fourth leading cause of death in the U.S., but there's about a 90 percent cure rate if the cancer is found early. That's why screening is so important.
Advanced screening methods and a new noninvasive DNA stool test are helping detect and treat this disease. The following are common questions I hear in my practice about colorectal cancer and the answers people of all ages should know:
1. Am I at risk for colorectal cancer?
Everyone is at risk for colorectal cancer. However, colorectal cancer is more likely to occur as we age. More than 90 percent of people are diagnosed after age 50, and the average age to be diagnosed is 72.
2. Does colorectal cancer occur in younger people?
Yes. In the U.S., approximately 4 percent of cases are diagnosed in people under the age of 50. Colorectal cancer is increasing in younger people, while decreasing in those 50 and above. The drop in occurrence in the latter group is largely due to increased screening. In particular, young-onset rectal cancer has increased in those younger than 50. If you are younger than 50 and exhibit symptoms, it is important to seek medical attention quickly so the appropriate testing can be done. If caught early, colorectal cancer has about a 90 percent cure rate regardless of age.
3. At what age should I be screened?
Talk to your doctor about when you should begin screening for colorectal cancer. Guidelines generally recommend screenings begin at age 50. If you are younger than 50, your doctor may recommend more frequent or earlier screening if you have other risk factors, such as a family history of the disease.
4. What are the symptoms of colorectal cancer?
Very often, colorectal cancer develops with few or no symptoms at all. When symptoms do begin, the cancer has often reached an advanced stage, reducing the chance of survival; therefore, recommended screenings are critical to your health. Whether you are older than 50 or younger, contact your doctor if you have any of the following symptoms:
- A change in your bowel habits, including diarrhea or constipation, or a change in the consistency of your stool
- Feeling that your bowel does not empty completely
- Rectal bleeding or finding blood (either bright red or very dark) in your stool
- Finding your stools are narrower than usual
- Persistent abdominal discomfort, such as cramps, gas, pain or feeling full or bloated
- Losing weight with no known reason
- Unexplained anemia
- Weakness or fatigue
5. What methods are used to screen for colon cancer?
The following methods are used to screen for colorectal cancer:
- Colonoscopy - A visual examination of the lining of the rectum and the colon with a flexible fiber-optic endoscope.
- Sigmoidoscopy - Examines your rectum and lower part of the colon with a lighted tube called a sigmoidoscope. This method is limited and only extends to the lower 40 centimeters of the colon and does not visualize the whole colon.
- Virtual colonoscopy - Also called a computed tomographic colonography (CTC), this procedure uses X-rays and computers to take two- or three-dimensional images of the interior lining of your colon and rectum. (Currently not approved by Medicare for colon cancer screening.)
At-home stool test - Also called a fecal immunochemical test (FIT), this test detects tiny amounts of blood in the stool, which is a possible sign of colon cancer.
Screening is the number one way you can reduce your risk of colon cancer. Despite its high incidence, colon cancer is unique in that it is one of the most successfully treated forms of cancer when found early. Unfortunately, screening rates are significantly below the American Cancer Society's goal of 80 percent by 2018.
6. I heard about a new, noninvasive stool test that detects DNA linked to colon cancer. How does that work?
In August 2014, the FDA approved a new stool-screening test that identifies colon cancer. It is roughly 90 percent accurate for detecting colon cancer, but has an 11 percent false positive rate. This test may appeal to people who want to be screened, but don't want to prepare for or undergo an invasive procedure. Like other screening tests, it's a new method in our arsenal of tests to find colon cancer early when it's easier to treat.
The good news about colorectal cancer is that most private insurance plans cover preventive colorectal cancer screening tests without out-of-pocket costs to the patient. Medicare also covers the cost of a preventive colonoscopy without a deductible. Those over the age of 50, exhibiting symptoms or at a higher risk than average of developing the disease should speak with their doctor about scheduling a colonoscopy. Screening saves lives.