Get screened to prevent risk of cancer

Colorectal cancer is the third most common cancer and second leading cause of death for both men and women in the United States, according to the American Cancer Society and the National Colorectal Cancer Roundtable. Colorectal cancer is cancer of the large intestine, comprising the colon and rectum. It is estimated that 152,800 new cases of colorectal cancers will be diagnosed in 2023. The Centers for Disease Control (CDC) stated in 2019 that 46.6 people out of 100,000 people were diagnosed with colorectal cancer in Louisiana. When race is accounted for, African Americans have a 20% higher risk of getting colorectal cancer in the state.

Colorectal cancer is not only a disease of older adults. Recent studies have shown that individuals born after the 1990s have twice the risk of colon cancer and four times the risk of colon cancer compared to those born in 1950. Experts suggest that increased sedentary lifestyles and poor eating habits may cause increased risk among young individuals.

An individual’s lifetime risk of developing colorectal cancer is 4.1%, translating to one in 23 men and one in 25 women. This risk increases further if an individual has a family history of colorectal cancer, high-risk colon polyps, small clumps of cells on the inside lining of the colon wall, or personal or family history of uterine or ovarian cancer below the age of 50. Other risk factors that can lead to the development of colorectal cancer are being overweight, smoking tobacco, excessive alcohol use, increased red meat and processed food consumption, having an inflammatory bowel disease such as Chron’s disease or ulcerative colitis and having a low vitamin D and low fiber diet.

It is recommended that individuals aged 45 and older should get colorectal cancer screening or earlier if they have a family history of colorectal cancer. A colonoscopy allows both screening for and removing colon polyps simultaneously. Studies have shown that removing colon polyps decreases the risk of getting colorectal cancer by 90%. Not all polyps become cancer; however, all colorectal cancers start as polyps.

Even healthy individuals who are not experiencing any symptoms should talk to their health-care provider about getting screened to prevent the risk of developing colorectal cancer. No symptoms do not equal no cancer, as it is common not to have any symptoms at the early stage of colon cancer. Some symptoms of colorectal cancer that one should pay attention to are unintentional weight loss, blood in stool, change in bowel habits, change in stool size, alternating diarrhea and constipation, abdominal pain, etc. If you have any of these symptoms, you should immediately notify your health-care provider and schedule a colonoscopy.

There are many ways to screen for colorectal cancer: stool-based test, FIT (Fecal Immunochemical Test) test, Cologuard®, a colonoscopy, Computed Tomography Colonography and capsule colonoscopy. Physicians from the American College of Gastroenterology recommend the FIT test (stool test for hidden blood) and colonoscopy as the top two screenings for colorectal cancer. The stool test is a two-step test, which checks for hidden blood in the stool. If the stool test returns positive, your health-care provider recommends colonoscopy as a second step.

In contrast, colonoscopy is a onestep test that allows for screening for and removal of precancerous polyps (if discovered during the procedure) in the same process. A colonoscopy is a procedure that is performed under light sedation. A colonoscope is a long flexible tube with a camera and light at the end of the tube that allows for examination of the large intestine. If polyps are detected, they are removed during the procedure and sent to the pathologist for further testing.

To prepare for a colonoscopy you will receive a prescription for bowel prep (a form of laxative) to clean your colon. A low-fiber diet is suggested a few days before the colonoscopy and a liquidonly diet the day before.

March is National Month. Help spread the word on the importance of screening for colorectal cancer to your loved ones by wearing a blue ribbon. Aligning with the American Cancer Society’s National Colorectal Cancer Roundtable, my goal is to raise awareness in the community about colorectal cancer and have 80% of the population undergo screening for colorectal cancer in every community and save a life.

Screening on time saves lives. If you are 45 and older, contact your health-care provider today about screening for colorectal cancer.

Sudha Pandit, MD, is an assistant professor of gastroenterology and hepatology at LSU Health Shreveport. Nazar Hafiz, MD, is a gastroenterology fellow at LSU Health Shreveport.