March is Colorectal Cancer Awareness Month
Mar 12
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March is colorectal cancer awareness month. As you read the information below, I want to emphasize that this cancer is affecting people younger and therefore the screening age has dropped to 45 to help decrease deaths in this age. Please get screened as recommended as there are options for everyone and most insurance covers screening well.
Here are some facts about colorectal cancer from https://fightcolorectalcancer.org
Overall colorectal cancer facts
1 in 23 men and 1 in 25 women will be diagnosed with CRC in their lifetime. (Source: SEER Cancer Statistics)
CRC is the #2 cause of cancer death in the U.S. (Source: American Cancer Society)
CRC is the #3 most diagnosed cancer among men and women.
152,810 new cases and 53,010 deaths are expected in 2024. (Source: SEER Cancer Statistics Factsheets)
There are an estimated 1,392,445 people living with CRC in the U.S. (Source: SEER Cancer Statistics Factsheets)
Between 25%-30% of CRC patients have a family history of the disease. (Source: NCBI)
Young people facts – these are alarming statistics to me as I am in this age range
The incidence of early onset colorectal cancer is expected to increase by more than 140% by 2030. (Source: American Cancer Society)
More than 27,000 people under age 50 will be diagnosed with CRC in 2030. (Source: American Cancer Society)
Among adults under 50, CRC is now the #1 cause of cancer death in men and the #2 cause in women. (Source: American Cancer Society)
The number of patients in the U.S. diagnosed under 55 years of age doubled from 11% in 1995 to 20% in 2019. (Source: American Cancer Society)
Screening Facts – See below for options and get screened!!!
There are more than 20 million Americans eligible for colorectal cancer screening who have not been screened.”(Source: CDC)
1 in 3 adults (ages 45-75) are not getting screened as recommended.”(Source: CDC)
When to Screen
When to start screening depends on a few things:
Age: If you’re age 45 or older, you need to be screened. You should get screened until age 75. At that time, ask your doctor about the risks versus the benefits of continuing to get screened.
Family history: If blood relatives have been diagnosed with colon cancer or rectal cancer, you may need to start screening at age 40 or earlier. The age to start will depend on their connection to you and their age at diagnosis.
Genetics: If you have certain genetic syndromes, you will need to start screening earlier and undergo screening more frequently than people without a genetic syndrome.
Symptoms: If you’re seeing any signs or symptoms of colorectal cancer, you will need medical evaluation right away—regardless of your age. (This is called a diagnostic work-up rather than a screening.)
Types of Screening
Colonoscopy
Colonoscopy has often been considered the “gold standard” for colorectal cancer screening because it can identify polyps and remove them during the same procedure.
Repeated every 10 years, if normal.
Performed at an outpatient surgical center or hospital.
Bowel prep required.
If you’re age 45 or older and you’re getting screened for prevention, your screening should be covered 100% and come at no cost to you. You won’t have to pay any out-of-pocket costs for it. Insurance should also cover the cost of polyp removal during the procedure if you have commercial insurance.
Complications are rare but can include bleeding, infection, and bowel-wall injury.
Most people are good candidates. This test is among the best ways to find and remove polyps early.
Colonoscopy is the only screening option if you’re experiencing symptoms or if you are at high or hereditary risk for colorectal cancer.
CT Colonography
A noninvasive, advanced CT scan that produces two- and three-dimensional images of the colon and rectum. The entire colon must be cleaned out for this procedure, just like a traditional colonoscopy. If abnormalities are found, your doctor will talk to you about the appropriate diagnostic procedure moving forward. Not everyone is a candidate for CT colonography, so be sure to talk to your doctor about this colorectal cancer screening option.
Should be covered by insurance but discuss with your insurance provider before undergoing this screening exam.
Requires bowel prep.
Repeat every 5 years, if normal.
It takes place at a hospital, clinic, or outpatient imaging center.
If any abnormalities are found, a follow-up colonoscopy is required.
May be a good option for people who aren’t eligible or cannot tolerate a traditional colonoscopy.
Cologuard
This is an at-home test that looks for abnormal sections of DNA within the stool in addition to small traces of blood. You will be given detailed instructions about how to use and return the kit at home, including where to send it when completed. Must be ordered by a clinician, most commonly a primary care clinician, although the tests can be ordered through urgent care centers, retail clinics, or independent telehealth providers.
One stool sample is needed.
Repeat every 3 years, if normal.
Performed at home.
No bowel prep required.
Screening tests must be covered by insurance.
Coverage for follow-up colonoscopy, if needed due to a positive test result, should also be covered by insurance. Cologuard’s patient assistance program can help patients facing challenges with insurance coverage.
It can’t detect or remove polyps. If you receive a positive test result, a follow-up colonoscopy within 90 days is required.
Many average-risk people are good candidates, especially if hesitant about a colonoscopy.
FIT (Fecal Immunochemical Test)
Stool is collected at home and sent to a lab, which looks for small amounts of blood. You will be given instructions about how to use the kit at home, and where to send it when completed. There are no drug or dietary restrictions to take the test. It’s recommended to obtain a test from your doctor so you use an accurate test, and so you can receive proper follow-up based on your results.
One stool sample is needed.
Repeat every year, if normal.
An affordable option for many patients.
Performed at home.
No bowel prep required.
Screening tests must be covered by insurance. Coverage for a follow-up colonoscopy, if needed due to a positive test result, should also be covered by insurance.
It can’t detect or remove polyps. If you receive a positive test result, a follow-up colonoscopy within 90 days is required.
Many average-risk people are good candidates, especially if hesitant about a colonoscopy and on a budget, but it must be performed every year.
cfDNA Blood Based Test (SHIELD)
In 2024, the FDA granted approval to the Shield test by Guardant, a cfDNA blood-based test. Using a blood draw, the test looks for cancer and pre-cancerous cells. Blood tests are highly effective at detecting colorectal cancer and have similar rates to other non-invasive tests for colorectal cancer screening. This means these tests have a high percentage of correctly identifying those who do not have colorectal cancer.
Blood tests are not as effective at identifying pre-cancerous polyps compared to many of the stool-based tests like FIT or mt-sDNA, or colonoscopy.
Many medical professionals are advising patients to understand that the blood test is strong in early detection of cancer, but not cancer prevention. Colorectal cancer is a highly preventable cancer, as pre-cancerous polyps can be removed before cancer grows.
A simple blood draw
Needs repeated every 1-3 years
If you receive a positive result, a follow-up colonoscopy is necessary.
May not be covered by insurance since it’s not yet included in screening guidelines.
It is best to call your insurance provider to determine screening tests that are and are not covered, and to work with your doctor on the best screening plan for you.
Signs and Symptoms of Colorectal Cancer
Blood in your poop – having blood in your stool does not always mean you have colorectal cancer, but it is not normal, and you should discuss this with your provider.
Pay attention to these details:
The color of the blood and/or poop
Whether the blood is on or in the poop
If the blood is on the toilet paper or in the toilet bowl
How often the blood occurs
Whether or not bowel movements are painful
If you have any other symptoms
If your provider recommends treatments and the blood persists, follow-up with your provider – you are your best advocate and you should know the reason for the blood in your stool
Funky Poop
Every poop is different, and every person poops differently. Poop can change because of what you’re eating, infections, medications you’re taking, or other medical issues. If you have not pooped for three days in a row —you should see a doctor.
Some people poop once per day; others poop a few times each day. If you notice your personal pooping schedule, or the way your poop looks, is changing—bring it up with your doctor. We know it can be embarrassing, but it’s nothing to be ashamed of. We encourage, urge, or challenge you to talk to your doctor about what is off with your poop. This conversation could save your life.
A few reasons to call the doctor:
If you’re consistently seeing anything but Normal (types 3 and 4).
If you’re passing watery, diarrhea-like stools for more than 24 hours.
If you have sudden urges to pass stool, but you can’t control it.
Your poop is black, clay-colored, red or white.
You see mucus or pus on your stool.
Stomach Pains
Severe abdominal pain is nothing to brush off.
If you’re experiencing gut-wrenching, knife-in-my-stomach type abdominal pains, visit an emergency room ASAP. You need to advocate for yourself to identify the cause of the pain; do not settle for medication that simply takes the pain away.
If you’re experiencing frequent, mild abdominal pains, it’s still important to get checked out and discover why.
Skinny Poops
Some people may be used to thinner stools, but super thin, pencil-like stools are something to keep an eye on and report to your doctor. Skinny poop can be caused by a lot of things, some are harmless and temporary conditions, and others may be serious. Low-fiber diets, temporary infections, irritable bowel syndrome (IBS), and colorectal cancer can all be at play.
Thin stools are a serious symptom because skinny poop may be caused by an obstruction in the colon, like a tumor. If you’re seeing skinny poop for more than a week, see a doctor.
For the most part, narrow stools that occur infrequently are not a cause for concern. But if you experience ribbon-like stools for more than a week, seek medical attention.
Losing Weight without Trying
Just because you’re losing weight without trying doesn’t mean you have colorectal cancer. But it is one of the symptoms of colorectal cancer which is why it is important that you get this symptom evaluated.
Amongst cancer patients, weight loss is often a result of cancer cells consuming the body’s energy as they multiply. In addition, your immune system is spending more energy to fight and destroy cancer cells.
If colorectal cancer is the specific cause of your weight loss, this may be due to the tumor blocking the colon or intestinal tract, preventing proper nutrient absorption. If you’re losing weight and you don’t know why, ask your doctor to help you uncover the underlying cause.
Can’t Fart
Most people release about 1 to 4 pints of gas a day and fart up to 21 times per day. (We’re not kidding!)
Any obstruction in the colon, including cancer, can hinder your ability to pass gas. The colon is in the abdomen, so if colon cancer is the cause of your bloating or pain, it is not uncommon to feel discomfort in that area.
If you can’t fart, or if you have a persistent feeling of fullness or stomach cramping, talk to a doctor.
Super Tired or Short of Breath
Like losing weight without trying, colorectal cancer symptoms can disguise themselves as constant weakness and fatigue.
Since cancer cells multiply unchecked, the constant, extra energy consumption can cause you to feel very tired—even when you’re had enough sleep and rest. Chronic fatigue and muscle weakness are most likely a sign of an underlying medical condition, even if it is not caused by colorectal cancer.
Anemia, also known as having low red blood cell counts, can be caused by internal bleeding. Many patients have learned they’re anemic after they try to give blood and are told they cannot. Others may go for routine bloodwork and find out they’re anemic in the lab report. Anemia often points to a medical condition that needs to be discovered.
If you experience fatigue, muscle weakness (that’s not related to working out), and/or you find out you’re anemic, talk to your doctor. These are all symptoms that could suggest colorectal cancer.
Hopefully, you have learned a few new facts and will discuss your colon cancer screening options with your provider. The earlier we can detect abnormalities, the better the outcome. I have had my colonoscopy, have you?
