Screening - Reduce Your Risk

Early detection in vital - over 80% of all cases of colon cancer could be prevented with recommended screening. 

Despite its high incidence, colorectal cancer is one of the most detectable and, if found early enough, most treatable forms of cancer. Over 90% of those diagnosed while the cancer is still localized survive more than five years. Currently, however, only 37% of colorectal cancers are detected while still localized.

Colorectal cancer can be present in people without symptoms, known family history, or predisposing conditions, such as inflammatory bowel disease. Regular screening will help identify pre-cancerous polyps and colorectal cancers earlier.
The Harvard Center for Cancer Prevention recently reported that regular screening, combined with a healthy lifestyle, can prevent over half of all colon cancer deaths in the United States. Primary prevention through polypectomy, or the removal of polyps, substantially reduces the risk of developing colorectal cancer.

Screening FAQ

How does screening save lives?
 Screening for colorectal cancer works in two ways: first, by finding cancers early when treatment is most effective; second, by finding growths (polyps) inside the colon and removing them before they become cancer; and second, by finding cancers early when treatment is most effective.

If screening works, why aren't more people doing it? 
Screening compliance rates are influenced by many factors, not least of which are:

• lack of public awareness about colorectal cancer and of the benefits of regular screening
• inconsistent promotion of screening by medical care providers
• uncertainty among insurance providers and consumers about insurance benefits and limitations on covered benefits
• characteristics of the screening procedures (e.g., imperfect tests, negative attitudes towards the screening procedures)
• absence of social support for openly discussing and doing something about "the disease down there"

What are the types of colon polyps? 
There are 4 types of polyps that commonly occur within the colon:

1. Inflammatory - Most often found in patients with ulcerative colitis or Crohn's disease. Often called "pseudopolyps" (false polyps), they are not true polyps, but just a reaction to chronic inflammation of the colon wall. They are not the type that turns to cancer. They are usually biopsied to verify type.
2. Hyperplastic - A common type of polyp which is usually very small and often found in the rectum. They are considered to be low risk for cancer.
3. Tubular adenoma or adenomatous polyp - This is themost common type of polyp and the one referred to most often when a doctor speaks of colon polyps. About 70% of polyps removed are of this type. Adenomas carry a definite cancer risk which rises as the polyp grows larger. Adenomatous polyps usually cause no symptoms, but if detected early they can be removed during colonoscopy before any cancer cells form. The good news is that polyps grow slowly and may take years to turn into cancer. Patients with a history of adenomatous polyps must be periodically reexamined.
4. Villous adenoma or tubulovillous adenomas - About 15% of polyps removed are of this type. These are the most serious type of polyp with a very high cancer risk as they grow larger. Often these are sessile and not on a stem making removal more difficult. Smaller ones can be removed in piecemeal fashion--sometimes over several colonoscopies. Larger sessile villous adenomas may require surgery for complete removal. Follow up depends on size and completeness of removal

Why remove polyps if they are benign?
Colon polyps are important, since some may turn into colon cancer over time. While not every colon polyp turns to cancer, it is felt that almost every colon cancer begins as a small non-cancerous polyp. Fortunately, during colonoscopy these polyps can be identified and removed or destroyed--thus preventing a possible colon cancer. If a polyp is large enough, tissue can be retrieved and sent for biopsy to determine the exact type of polyp.

What are my options for screening?
Professional guidelines emphasize the importance of a regular screening program that includes annual fecal occult blood tests (FOBT), periodic partial or full colon exams, or both. Leaders in the field have estimated that, with widespread adoption of these screening practices, as many as 30,000 lives could be saved each year.

Screening Guidelines

American Cancer Society Guidelines on Screening and Surveillance for the Early Detection of Colorectal Adenomas and Cancer — Average-Risk Women and Men Ages 50 and Older

The following options are acceptable choices for colorectal cancer screening in average-risk adults. Since each of the following tests has inherent characteristics related to accuracy, prevention potential, costs, and risks, individuals should have an opportunity to make an informed decision when choosing a screening test.

American Cancer Society Guidelines on Screening and Surveillance for the Early Detection of Colorectal Adenomas and Cancer — Women and Men at Increased Risk or at High Risk