by Stephen S. Grubbs, M.D.
In Delaware and in the United States, colon cancer arising in the large bowel — also known as colorectal cancer — is the third-most commonly diagnosed cancer in men and women, and it’s also the second-most common cause of cancer death. Although it is possible to develop colon cancer at any age, 90 percent of diagnoses happen after age 50.
The most stunning fact about colon cancer deaths — predicted to be more than 50,000 this year — is that they are, for the most part, preventable.
In most cases, people develop colon cancer because of growths called polyps. Polyps can form in the colon and, over time, become cancerous. A colon cancer screening called a colonoscopy can find polyps and eliminate them before they become cancerous.
The current guidelines established by the Centers for Disease Control and Prevention recommend that people age 50 and older get a colon cancer screening. There are two recommended screening approaches:
- A colonoscopy — A procedure performed by a health care provider called a gastroenterologist, who looks at your colon using a special technology to locate polyps that could become cancerous. The gastroenterologist can remove polyps on the spot, if they are found, to decrease the future risk of colon cancer. This test should be repeated every 3 to 10 years depending on the findings and you will be advised by your physician.
- A fecal immunochemical test (FIT) — A test that looks for hidden blood in your stool, which can be a sign that you are at risk for colon cancer. The test is done at home, where you collect several samples of your stool and then send those samples to a lab for testing and the test should be repeated every year if normal.
Many people resist the idea of a colonoscopy because of the required preparation to cleanse the colon the day before. It requires taking a strong laxative, which may be inconvenient. But it can’t begin to be as daunting as a cancer diagnosis that could be life-threatening.
You may need a colorectal cancer screening before age 50 if you are at greater risk for colon cancer. You’re at greater risk if you:
- Use alcohol in excess
- Are obese
- Live a sedentary lifestyle
- Have Type 2 diabetes
- Are African-American
- Have a history of noncancerous polyps
- Have a history of colon cancer
- Have a history of inflammatory bowel disease, ulcerative colitis, or Crohn’s disease
A routine colonoscopy is the preferred screening, but other effective screening (FIT, virtual colonoscopy, fecal DNA) is better than no screening. The Harvard Center for Cancer Prevention released a report stating that a combination of routine screening and lifestyle changes can help prevent half of all colon cancers. The report recommends getting regular exercise; maintaining a healthy weight; eating fruits, vegetables and whole grains; avoiding tobacco; and limiting alcohol consumption.
As with many cancers, there are usually no symptoms in the early stages of colon cancer. Symptoms that occur in the advanced stages might include low red blood count (anemia), rectal bleeding, blood in the stool, change in bowel habits, persistent abdominal pain, weakness and/or unexplained weight loss. If you are experiencing any of these symptoms, you should contact your doctor immediately.
Talk to your health care provider about your risks, and discuss which screening is best for you. It’s important to get screened. If you don’t have insurance or if your insurance won’t cover these screenings, there’s a program in Delaware called Screening for Life that can help. If you are a Delaware resident age 40 to 64, or if you are 65 or older and don’t qualify for Medicare, if you don’t have health insurance, or have health insurance that doesn’t cover screenings — and you meet the income guidelines — you could be eligible for a colon cancer screening through Screening for Life. You can learn about Screening for Life and also ask a nurse navigator to schedule a screening for you by visiting HealthyDelaware.org.
If you have been diagnosed with cancer, you may be eligible for assistance with covering cancer treatment costs for up to two years. Visit our Delaware Cancer Treatment Program page or call them at 1-800-996-9969 to find out if you are eligible.
Stephen S. Grubbs, M.D. is a member of the Delaware Cancer Consortium, a group of volunteers from all walks of life who contribute their insight, ideas and time to help reduce the burden of cancer in Delaware.