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Colon Cancer Screening: It’s Not Nearly as Bad as You Think

Neeta Goel, is a primary care physician board-certified in family medicine. She is a member of Inova Medical Group and practices at Inova Primary Care – Ashburn HealthPlex.

We’re deep into Colorectal Cancer Awareness Month, but you may have been tuning out the messages.

It’s understandable. Nobody likes to think about the possibility of having cancer. But there’s good reason to tune back in. If you’re anxious about the thought of a colonoscopy, you have alternatives. Doctors now have several options to screen patients for colorectal cancer.

Colorectal Cancer Screening Options

Here’s what you should know about your colon cancer screening options:

  • Colonoscopy. This procedure is considered the gold standard for diagnosing colon cancer. After taking a laxative to clear the bowels, you’ll be given a mild sedative before a doctor inserts a scope into your colon. The scope is fitted with a small video camera so your doctor can look for signs of cancer or precancerous growths called polyps. Polyps can also be removed during a colonoscopy. For healthy people at low risk of colorectal cancer, we recommend a colonoscopy every 10 years.
  • Cologuard®. This test analyzes stool samples to detect DNA markers associated with colorectal cancer. Unlike a colonoscopy, this test isn’t a procedure at all — so it doesn’t require sedation or cleaning the bowels. It’s not a surprise, then, that it’s more appealing for many patients. But the test can be expensive (though more and more insurance companies are covering it), and if you receive a positive test result, you’ll still need to follow up with a colonoscopy. Cologuard is a great choice for people at low risk of colorectal cancer. If you choose Cologuard screening, we recommend getting tested every 3 years.
  • Virtual colonoscopy. This noninvasive test X-rays the colon and rectum to look for possible signs of cancer. If the result is positive, your doctor will likely recommend a colonoscopy for further testing. Several years ago, this “virtual colonoscopy” was becoming popular as an alternative to colonoscopy. Unfortunately, researchers haven’t found enough evidence that it saves lives. Cologuard is usually a better noninvasive option, if your insurance covers it.
  • Fecal occult blood tests. This test looks for traces of blood in the stool. If you have a positive fecal occult blood test, a colonoscopy will likely be the next step. This test isn’t as definitive as other screening tests at identifying colorectal cancer. That’s why we don’t usually recommend it unless other tests aren’t covered by a patient’s insurance.

What test is best? It depends. Talk to your doctor about the best option for you. It’s an important step for your health and your peace of mind.

Colorectal Cancer Screening Advice

Colorectal cancer is the third most common cancer in the United States, for both men and women. But it doesn’t always cause symptoms, especially at earlier stages. When it does, they are often vague (such as upset stomach, cramps or bloating). Luckily, screening tests do a great job of catching cases of colorectal cancer, with or without symptoms.

For people with an average risk of colorectal cancer, we recommend regular screenings begin at age 50 and continue until 75.

But some factors increase your risk of being diagnosed with colorectal cancer. These include:

If you fall into one of those categories, your doctor can help you decide if screening before age 50 is a good idea.

For more information, schedule an appointment with your primary care provider.  To find an Inova Medical Group primary care physician, click here or call 855-IMG-DOCS (855-464-3627).

2 Comments

  1. Carrie on March 21, 2019 at 9:08 am

    This article is misleading in its representation of fecal occult blood tests for the screening of colorectal cancer. The older guiac-based FOBTs are generally not recommended as the newer fecal immunochemical tests are more effective and don’t require dietary restrictions. Studies have shown FIT tests to be highly effective at reducing mortality from CRC, such as this study from Taiwan: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4676309/.

    Inova physicians should adopt in their practice the standard of offering average risk patients screening options because cost is not the only reason someone might want to avoid a colonoscopy. The procedure is invasive and there are risks involved. The prep is unpleasant. A colonoscopy might not be the first line approach for the average risk patient who has bleeding issues or other medical considerations; FIT test is a good option for them. The National Colorectal Cancer Round Table has shown that offering patients a choice in screening options increases their likelihood of adherence to screening recommendations. http://nccrt.org/wp-content/uploads/IssueBrief_FOBT_CliniciansRef-Draft-15.pdf

    While it is great to advise the public to get screened, perhaps update physicians and clinic staff on the best practices in screening and making recommendations. My physician did not walk through a risk assessment with me, nor were the screening options discussed. Patients are most likely to get screened with a recommendation and a choice. Let’s make sure they are getting one with all the options discussed.

  2. Pam on March 21, 2019 at 9:43 pm

    Cologuard test is not recommended for those who have a family history of colon cancer.
    Check with insurance to know exactly what it will pay for if you have a family history of colon cancer and over 50.

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