Is It Time for My Colonoscopy Again?

By Erin Wolf, APRN

“Have you had your colonoscopy?” This is a question your primary-care provider may ask you during your annual visit. You might dread the question (and the procedure), but it’s an important part of preventing colorectal cancer.

According to the American Cancer Society,  colorectal cancer is the third leading cause of cancer-related deaths. However, it’s preventable if found and treated early, and the key to preventing it is proper screening. In fact, studies have shown screening has reduced the risk colorectal cancer by 40% and of death from colorectal cancer by 65-70%.

Colorectal cancer is a cancer of the colon or rectum, the lower end of your digestive system. Most colon cancers develop from polyps or growths on the inner lining of the colon. There are several different types of polyps and not all polyps are cancerous. Identifying and removing these polyps can reduce the risk of colorectal cancer developing. Early screening is important because people may not have any symptoms until later stages of the disease.

Currently, the American Cancer Society recommends colorectal screening for all adults between 45 and 75 years old. Older adults aged 76-85 should be screened based on their health history and their risk for cancer. But which choice of screening is your best option?

• Fecal occult blood test: A test that uses a special chemical to detect blood in your stool. A small sample of stool is placed on a card or in a special container and tested for blood in the lab. This type of test is recommended yearly.
• Fecal immunochemical test (FIT): A test that uses antibodies to detect blood in your stool. This testing is recommended yearly.
• FIT-DNA test or Stool DNA test (Cologuard): A test that combines FIT testing with a test to detect altered DNA in your stool. This is an at-home test that requires the collection of a full bowel movement. It’s sent to a lab and checked for altered DNA and blood. This test is recommended every 3 years.
• Flexible Sigmoidoscopy: This test is performed by a doctor. The doctor puts a short, thin flexible tube with a camera into the rectum to check for polyps in the lower part of the colon. This testing is recommended every 5 years.
• Colonoscopy: Considered the gold standard for screening, this is like a flexible sigmoidoscopy but examines the entire colon. The doctor is also able to remove polyps and test them for cancer during this process. This test is recommended every 10 years but may be required more frequently depending on risk factors and results.  A colonoscopy would also be required if any of the above tests were abnormal.

Although all these types of testing are options for colorectal cancer screening, your primary-care provider will recommend the appropriate option based on your particular situation. Your family history and other personal risk factors for colorectal cancer will determine which screening is best for you. You should discuss all the options with your primary-care provider.

• Eat high fiber diet with whole grains, fruits, and vegetables. The fiber helps move potential cancer-causing foods through the intestine faster, reducing the time in the intestine
• Avoid Red meat and processed meats
• Limit alcohol: Moderate to heavy drinking (2-3 drinks per day) increases the risk of colon cancer
• Increase physical activity: Studies by the National Cancer Institute have shown physical activity can reduce the risk of colon cancer by 20%
• Quit smoking: People who smoke may have larger and more colon polyps, increasing their risk of colon cancer

With reduction of risk factors and early prevention, colorectal cancer can be prevented. Please consult with your primary-care provider and don’t be afraid to ask them, “Am I due for my colonoscopy?”