As a Cleveland Clinic Weston Hospital colorectal surgeon and vice chair of research at the Digestive Disease Institute in Florida, Marylise Boutros, MD, values the tools she has at her disposal to provide good outcomes for her patients who have digestive conditions and cancer. She points to the colonoscopy, the gold standard for screening colon cancer, a leading cause of cancer death in the United States.
“It’s gratifying to be able to prevent a common cancer by performing a simple procedure on a patient,” she says. “The colonoscopy is rated so highly because it not only detects polyps in the colon, but also allows us to remove them before they develop into cancer.”
Thanks to regular screenings, the overall rate of colon cancer has been trending downward over the past 10 years. However, the incidence in adults under the age of 50 has been rising.
As a result, the American Cancer Society now recommends starting regular colon cancer screenings at age 45. Those who are at increased risk of colon cancer, based on family history or other factors, may need to start screening before age 45.
“We have different options to consider when it comes to colon cancer screening tests,” says Dr. Boutros. “This is an important and personalized discussion to have with your doctor.”
Factors to consider with your doctor include: how long the test will take; what prep is required; how often it needs to be repeated; whether you need sedation; the accuracy of the test to detect cancer and/or polyps; and the potential for follow-up testing if there is a positive finding or a need to remove tissue. Your individual risk for colon cancer may also influence your choice of screening tests.
Visual exam vs. stool-based tests
Colonoscopy and CT colonography are classified as visual exam tests. The latter is a quick CAT scan reserved for patients who are unable to undergo a colonoscopy for various reasons. Both tests require bowel prep and are performed in a health facility. They provide the physician with a view of the entire colon and rectum. The difference is that a colonoscopy allows on-the-spot removal of any polyps that are identified, while a CT-colonography requires a follow-up colonoscopy to remove polyps, if found.
Stool DNA tests require collecting a stool sample and sending it to a lab. They are performed at home and don’t require bowel prep. These tests look for blood in the stool and DNA changes in cells that might indicate the presence of colon cancer or precancerous conditions. The downside is the test’s inability to detect small polyps and the need for a follow-up colonoscopy if the test results are abnormal.
“Regular screening is one of our most powerful tools in the fight against colon cancer,” says Dr. Boutros. “The most important thing is to get screened, no matter which test you choose. It could be a lifesaving decision.”
Call 877.463.2010 to schedule an appointment with Dr. Boutros or another digestive disease specialist at Cleveland Clinic. Visit ClevelandClinicFlorida.org/Colonscopy to learn more.
