While screening colonoscopy is considered the “gold standard” for colon cancer prevention, there are other options that may be available for people at average risk.
The simplest screening is a stool test for blood, also known as FIT (Fecal Immunochemical Testing). This test detects cancers and polyps that may have trace bleeding at the time the stool is collected. It is generally recommended every year after the age of 50 and has been shown to have 87 percent sensitivity for picking up colon cancer (13 percent of the time, a colon cancer is missed) and a 98 percent specificity for colon cancer (2 percent of tests are false positives). You simply brush the stool in the toilet and send the swab in for analysis. As one can guess, there is absolutely no risk from this procedure, and it has minimal cost. Should a positive result be found, a diagnostic colonoscopy would be ordered.
Another new home test known as Cologuard requires you to submit a whole stool sample by mail for DNA analysis, which looks for a “fingerprint” of cancer and polyps. Cologuard finds 92 percent of colon cancer; however one in six patients’ results may have false positives, resulting in unnecessary diagnostic colonoscopies. This test is recommended every three to five years.
Still, screening colonoscopy is the most commonly utilized test for colon cancer as it can detect precancerous polyps as well as remove them. The procedure uses a colonoscope, a tube with a light and video camera on the end, which allows the doctor to see the entire colon. If a polyp is found, it can be immediately removed and sent for analysis. Colonoscopy is generally recommended every ten years for those at average risk, and every three to five years for those at higher risk.
In addition to regular screenings, prevention is paramount. I advise my patients to abstain from smoking and drinking, avoid over processed foods, exercise regularly and to eat a plant-based diet, including fruits, veggies, nuts, beans, lentils and whole grain. The benefit of this approach is illustrated in a study comparing colon cancer rates in African Americans vs. Native Africans, where African Americans were found to be at considerably higher risk for developing colon cancer due to the American diet. In the study, African Americans ate significantly more protein, meat, fat and cholesterol compared to native Africans who ate more starchy foods such as cornmeal, and meat was used in only small quantity as a dressing or flavoring.
Colon cancer is the second leading cause of cancer-related deaths in the U.S. Yet, we’re making progress – the number of people diagnosed with colon cancer has declined 30 percent in the past ten years since reimbursement for screening colonoscopy was introduced. If you’re 50 or older, or have a family history of colon cancer, talk to your doctor about which test is right for you and get tested as often as recommended. If found early, colon cancer can be highly treatable and curable.