Catch up on Colon Cancer Screening

According to the World Health Organization, colorectal cancer is the 3rd most common cancer among men and the 2nd most common among women. In the US, we have more than 153,000 new cases of colorectal cancer diagnosed each year and about 55,000 deaths. Death rates have declined across the world since the 1980s and this is largely attributable to improvement in screening guidelines and techniques. This week an article in New England Journal of Medicine detailed the promising new blood test to detect early colon cancer which could drastically change how we screen for this cancer.

Risk Factors for Developing Colorectal Cancer

• Genetic syndromes that predispose people to various cancers

• Obesity

• Red-meat consumption

• Fatty liver disease

• Family history of colorectal cancer in 1st degree relative

• Alcohol consumption

Symptoms of Colon Cancer -

If screening guidelines are followed - most cancers will be caught prior to symptom development and therefore at a very early stage (aka more treatable).

• Change in bowel habits

• Rectal bleeding

• Rectal mass

• Iron deficiency anemia noted on labs

• Abdominal pain (uncommon as independent symptom)

Screening Recommendations:

The United States Preventative Task Force recommends initiating screening for colorectal cancer at age 45 for those at AVERAGE risk for this disease.

• The age at initial screening was decreased from age 50 to age 45 about 5 years ago

Modes of screening

• Colonoscopy - every 10 years (if normal and average risk)

• FIT testing (stool card) - every year and only recommended if patient is unwilling or unable to have a colonoscopy

• Stool DNA testing - every 3 years, insurance coverage is variable

New Screening Option on the Horizon

On March 13th, 2024, researchers published the results studying a new cell-free DNA blood testing option for colon cancer screening. The study, "A Cell-free DNA Blood-Based Test for Colorectal Cancer Screening,"included about 7800 people. It found the blood test to be 83% specific (effective) for detecting colon cancer in patients that had no symptoms suggesting colon cancer. Typically the test was better at detecting advanced cancer which can be harder to treat than early disease typically found by colonoscopy. About 10% of patients had a false - positive test and went on to have no cancer on colonoscopy. The test option has NOT been approved by FDA currently. But could be another options for patients who decline colonoscopy in the future.

Regardless of how you choose to screen, colon cancer screening is a crucial step in protecting our health. By advocating for screenings, we can detect and treat this disease early, saving lives. Let's prioritize our well-being and work towards a future where colon cancer is no longer a leading cause of cancer-related deaths. Take charge of your health today and schedule that screening—it could save your life.

Link to Study Results