Sarah Cannon - August 21, 2019

Preventing colon cancer together

Dr. Johanna Bendell

Colorectal cancer screenings are an important step toward early diagnosis, but many people avoid colonoscopies because of fear of discomfort. With the increase in incidence of colorectal cancer in younger age groups, Sarah Cannon and other organizations including the American Cancer Society are recommending screening start as early as 45 years old. Sarah Cannon recommends a flexible sigmoidoscopy every five years or a colonoscopy every 10 years for both men and women with average risk. Adults age 76-85 should discuss the decision to screen with their physician. People with known risk factors should talk to their doctor about earlier or additional screenings. According to figures from the Centers for Disease Control and Prevention (CDC), one quarter of adults 50-75 years old have never been screened.

Fecal immunochemical tests

A Fecal Immunochemical Test or FIT kit is an at-home test that screens for occult or hidden blood in the stool that could be a sign of precancerous polyps or colon cancer. A trained nurse navigator specialized in GI cancer will follow up with participants of FIT kits regarding their results and serve as a guide to schedule additional testing and coordinate insurance needs.

While the FIT should not replace colonoscopies, the test is a way of improving the community's health awareness and ultimately getting those in need of healthcare scheduled for necessary appointments.

"Ideally, we would like everyone over the age of 45 to receive a colonoscopy and those with a family history of colon cancer to begin screenings even earlier. One out of three people in that age group has not been screened for colon cancer," says Johanna Bendell, MD, Chief Development Officer, Director of the GI Cancer Research Program and Director of the Drug Development Program at Sarah Cannon. "With the FIT kits, there's an 80 percent compliance rate, which increases early diagnosis. Patients can find out if they are at increased risk for colon cancer and should undergo additional testing."

Making screenings more patient-friendly

FIT kits are just one of a number of patient-friendly screening options that have become available for colon cancers. Other screening options include CT colonography ("virtual colonoscopy"), fecal occult blood tests (FOBT) and Given Imaging's PillCam technology for colon cancer. There is also a fecal-based, non-invasive DNA screening test for colorectal cancer available that couples sensitivity toward patient preference for less invasive options with the demand for more reliable screening methodologies.

While some of these new screenings may be less effective than more invasive procedures and may lead to false positives, Dr. Bendell pointed out that these alternative methods are better than no screening at all, especially for patients who would otherwise forgo screening.

"It's always better to get some information as opposed to none at all. We want to take whatever steps we can do to catch cancer when it's in an operative, treatable stage," she says. "This is especially true for colon cancer, which tends to mutate as it progresses, making it resistant to various treatments. If we can detect the polyps before they become abnormal, we can help to prevent the cancer altogether."