Get the facts on colon cancer screening

As March is National Colorectal Cancer Screening Month, we turned to a noted physician to get the facts on colon cancer prevention. Here, Dr. Thomas Capozza, MD, of PrimaCARE Gastroenterology and a member of Saint Anne’s Hospital’s medical staff, shares his expertise in colon cancer screening and prevention.

In brief: What is colorectal cancer?

Colorectal cancer is a malignant (cancerous) growth inside the colon (large intestine) or rectum; about 135,000 people developed colorectal cancer in the U.S. in 2017 and about 50,000 died from colorectal cancer in the U.S. in 2017.

When should someone get a colonoscopy, and how frequently?

An average risk person (someone without a family history of colorectal cancer) should start having colonoscopies at age 50 and then repeat every 5 to 10 years depending on the findings from the exam.

Has the age recommendation for screenings in general been lowered recently?

For the average risk population, the age recommendation (i.e., starting at age 50) has been the same for many years. However, the U.S. Multi-Society Task Force on Colorectal Cancer has suggested that African-American individuals start screening at age 45.

Who’s at risk?

Anyone who has a colon is at risk for colorectal cancer; however, for the general population the risk is really low until you reach your 50s and then it starts to rise slowly with each decade. The lifetime risk of developing colorectal cancer in an average American is 4 to 5 percent (that number more than doubles if you have a family history of colon cancer in a first-degree relative). Colorectal cancer is the third most common cancer in the U.S. for both men and women, but it is the second most common cause of death from cancer in men and women.

Are there different screening age recommendations for different races/ethnic backgrounds?

Yes, see above answer for African-Americans.

Can colorectal cancer be prevented?

Yes, by getting colorectal cancer screening at the appropriate age and interval. Studies have shown a steady decrease in the death rates from colorectal cancer over the past 20 years. And recent data suggests that approximately 50 percent of the reduction in colorectal cancer deaths is directly due to screening colonoscopies.

Are men more susceptible?

Yes, males have a slightly higher chance of developing colon polyps and colorectal cancer compared to females. About 30 to 35 percent of men over the age of 50 have colon polyps and about 20 to 25 percent of women over the age of 50 have colon polyps.

Should I have a colonoscopy if I feel OK and don’t have any symptoms?

Yes, colorectal cancer can be silent until it’s too late. If an individual is of the appropriate age, they should undergo some form of colorectal cancer screening, regardless of symptoms.

What are some of the signs that might warrant a colonoscopy outside of recommended screening ages?

Some of the warning signs include rectal bleeding, unexplained change in bowel habits (especially a decrease in the stool caliber), unexplained weight loss, and anemia (low red blood cell count)

What’s the difference between a polyp and a cancerous nodule?

A polyp is a non-cancerous or pre-cancerous growth inside the intestines. Over several years (typically about eight to 10 years), a pre-cancerous polyp can develop into a cancerous nodule and then into invasive cancer.

Why is early detection important?

When we detect polyps during a colonoscopy, we can safely remove them before they have a chance to develop into cancer. As mentioned above, by removing pre-cancerous polyps, we have decreased the death rates from colorectal cancer over the past 20 to 30 years. In addition, screening colonoscopy has been shown to diagnose colorectal cancers at an earlier stage — the earlier the diagnosis the more likely the individual can be completely cured.

SAH’s Endoscopy Center of Excellence was recognized by the American Society of Gastrointestinal Endoscopy in 2016.