Colorectal Cancer Awareness Month

My first colonoscopy was 11 years ago, at age 55. I was due for another one 10 years later, in early 2021. Due to the COVID pandemic, the clinic doing colonoscopies in my community was forced to cancel all but the most urgent procedures. When I saw my family doctor last month, he mentioned I was overdue for my next colonoscopy.

“They called me last week to schedule it, but I haven’t called them back.”

He reminded me that by avoiding getting tested, I was gambling with my life. March is Colorectal Cancer Awareness Month. Colon and rectal cancers are the second leading cause of death from cancer in the United States, behind lung cancer.

According to the National Cancer Institute, nearly 150,000 new colon or rectal cancer cases were discovered last year. That’s one out of 23 men and one out of 25 women. Colon and rectal cancers are often lumped together and called colorectal cancer or CRC. CRC is the cause of 10% of all cancer deaths.

Colorectal cancer was rare in 1950 but is now the fourth most commonly diagnosed cancer in the United States. You are more likely to develop CRC if you are older, smoke cigarettes, are obese, get minimal exercise, or eat a diet high in meat and refined carbohydrates and low in fiber. Colon cancer is more common among women, but rectal cancer is more common in men.

The incidence of CRC increases starting at age 40 and peaks between 60 and 75 years of age. 20% of CRC cases are related to genetic factors. Having ulcerative colitis and Crohn’s disease increases your risk of developing CRC. Polyps are clusters of cells that grow on the inside lining of your colon. Colorectal cancer can occur when the tissue clump called a polyp turns normal cells into cancer. Without polyps to change into cancer cells, there’s no colorectal cancer.

When should screening for colorectal cancer start? It depends on estimating your risk of developing this reasonably common cancer. If you have an average chance of getting CRC, screening tests should begin at age 50 and continue until age 75.

What type of screening is best? A colonoscopy is considered the “gold standard” for screening for colorectal cancer. If no polyps are found, it should be repeated in 10 years, sooner if you have other characteristics that increase your risk of developing CRC.

During a colonoscopy, your surgeon looks for polyps by inserting a tiny camera mounted to the end of a long, narrow, flexible tube. This tube snakes through your rectum and up and around your colon and intestines, inspecting the tissues as it goes by. For a successful colonoscopy, enough fecal material must be flushed out so that the lighted scope can see the inside of your intestines clearly.

Small and medium-sized polyps are removed during the procedure by the surgeon. Larger polyps can require additional surgery. Another option for CRC screening is a sigmoidoscopy. Less invasive than a colonoscopy, it checks just the lower part of your colon instead of its entire length.

The third CRC screening option doesn’t require a procedure. Called a fecal immunochemical test or FIT test, it involves testing a sample of your feces for blood. Since no polyps were found at my last colonoscopy, my doctor said I could do a FIT test at home instead of waiting for another procedure.

“I don’t have to chug a gallon of weird-tasting liquid? Count me IN!” Smiling, I carried home my FIT test packet: a small squeeze bottle with tape wrapped around it. Following the instructions, I dropped off my sample last week. Whoohoo! Here are 4 Final Facts about Colorectal Cancer Screening:

1. Don’t put it off. Despite advances in the treatment of colorectal cancer, the rate of survival and percentage of people cured has remained the same. This is why screening is so essential to detect cancer at the most curable stage.
2. Watch for bleeding from your rectum. Rectal bleeding when going Number 2 is the most common initial symptom of colorectal cancer. Don’t assume it’s from your hemorrhoids.
3. Chill out. Mix up your gallon of colonoscopy preparation fluid the day before, and chill it overnight. Drinking it cold reduces the “soapy” taste reducing the “yuk” factor.
4. Don’t fall behind. Keep to the schedule of drinking your liquid colonoscopy preparation. I fell asleep, then tried to catch up by drinking a double dose. If I thought it tasted weird going down, it tasted even worse, coming back up!

Dr. Louise Achey, Doctor of Pharmacy, is a 43-year veteran of pharmacology and author of Why Dogs Can’t Eat Chocolate: How Medicines Work and How YOU Can Take Them Safely. Get clear answers to your medication questions at her website and blog TheMedicationInsider.com. ©2022 Louise Achey