Colorectal Cancer Screening

In the United States, colorectal cancer (CRC) is the second most frequent cause of cancer-related death. Several screening options are endorsed for average risk CRC screening and have been shown to favorably affect both incidence and mortality outcomes. 

The Healthy People 2020 objective for CRC screening is to increase the proportion of adults aged 50 to 75 years receiving guideline-recommended screening to 70.5%, whereas the National Colorectal Cancer Roundtable has set an even more ambitious goal of 80% screening participation in every community. 

Currently, the levels of screening are well below that goal, with nearly one-third of eligible adults in the United States reportedly not up to date with their recommended CRC screening. 

The usual recommendation is that people with an average risk of colon cancer begin screening around age 50. But people with an increased risk, such as those with a family history of colon cancer or African-American heritage, should consider screening sooner. 

When Should You Begin to Get Screened? 

Most people should begin screening for colorectal cancer soon after turning 45, then continue getting screened at regular intervals. However, you may need to be tested earlier than 45, or more often than other people, if—

• You or a close relative have had colorectal polyps or colorectal cancer.
• You have an inflammatory bowel disease such as Crohn’s disease or ulcerative colitis.
• You have a genetic syndrome such as familial adenomatous polyposis (FAP)
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•  or hereditary non-polyposis colorectal cancer (Lynch syndrome).

The use of colonoscopy is the most frequently preferred option for average-risk patients, favored by 96.9% of gastroenterologists and 75.7% of primary care physicians. 

While colonoscopy is the most often recommended screening method, a new study by the Mayo Clinic found that preferences of primary care physicians shifted toward noninvasive options in general and particularly for patients who were unwilling to undergo invasive procedures, concerned about taking time from work, or unconvinced about the need for screening. 

Previous research has demonstrated that the common practice of recommending colonoscopy only may reduce the number of patients who undergo screening and that offering other noninvasive screening options is associated with greater adherence to testing. 

It is very important that you speak with your primary care doctor if you have any of the previously mentioned conditions that put you at an increased risk of colorectal cancer or if you are around the age of 45-50 years. Colorectal cancer is a highly prevalent condition that could be preventable and treated if detected in early stages. 

Sources:

Lila J. Finney Rutten, et al. Health Care Provider Characteristics Associated With Colorectal Cancer Screening Preferences and Use. Mayo Clinic. 2021. https://doi.org/10.1016/j.mayocp.2021.06.028.

Jay Furst. (2021, Dec 14). Primary care clinicians adjust recommendations for colorectal cancer screening to accommodate patient needs and preferences, study finds. Mayo Clinic. Retrieved from:
https://newsnetwork.mayoclinic.org/discussion/primary-care-clinicians-adjust-recommendations-for-colorectal-cancer-screening-to-accommodate-patient-needs-and-preferences-study-finds/ 

https://www.mayoclinic.org/diseases-conditions/colon-cancer/symptoms-causes/syc-20353669

https://www.cdc.gov/cancer/colorectal/basic_info/screening/index.htm

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