General colorectal cancer screening questions

Why is colorectal cancer screening important?


Screening can help find precancerous polyps — abnormal growths in the colon or rectum. When these polyps are detected at an early stage, they can be removed before they become cancerous. Screening is important because, when found early, colorectal cancer is preventable. According to the American Cancer Society, screening for colorectal cancer should begin at age 45.




Who should be screened for colorectal cancer?


Women and men 45 years of age and older are considered at average risk for colorectal cancer. People with a history of polyps, previous CRC, inflammatory bowel disease or family history of CRC, polyps, Chron's Disease or genetic syndromes like Lynch syndrome (hereditary non-polyposis colorectal cancer) or FAP (familial adenomatous polyposis) are considered high risk for developing colorectal cancer and should be follow screening guideline for high risk populations.




At what age should colorectal cancer screening start?


The American Cancer Society recommends people of average risk begin screening for colorectal cancer at the age of 45. People with increased risk, such as those with family or personal history of colorectal cancer, should begin screening at a younger age.




Is colorectal cancer hereditary?


Yes. Colorectal cancer/colon cancer can be hereditary. A family history of colorectal cancer or colorectal polyps increases a person's risk of developing colorectal cancer. If you have family history of colorectal cancer it is critical that you get screened.




What is a Fecal Immunochemical Test (FIT)?


  • Fecal immunochemical tests (FIT) detect small amounts of blood in stool which can be an early sign of colorectal cancer. Patients do not have to change their diet to medication routine to take the test and there is no preparation involved. It is easy to use and can be done at home.




Why is a fecal immunochemical test (FIT) necessary?


A fecal immunochemical test (FIT) can detect small amounts of blood in the stool which may not be visible to the naked eye.




If a fecal immunochemical test (FIT) test is positive, should it be repeated to confirm the result?


A positive or abnormal FIT result indicates that there was blood in your stool at the time of the test. However, the presence of blood can be from causes other than cancer. Your doctor will advise you on what further tests need to be done to determine the source of your issue. Positive results are usually followed by a colonoscopy.




How often should a fecal immunochemical test (FIT) test be performed?


The Screening guidelines recommend that for people of average risk, over the age of 45, fecal immunochemical tests (FIT) be done once per year.




Does a positive Fecal Immunochemical Test (FIT) result mean I have cancer?


A positive fecal immunochemical test (FIT) only indicates that blood was detected in your stool. The bleeding could be from conditions other than colorectal cancer. If you have a positive result, it is best to discuss the result with your physician to establish the source of the bleeding. Often a further test of the colon and rectum, such as a colonoscopy, is recommended following a positive FIT result.




What are the patient benefits of fecal immunochemical testing?


The benefits of a fecal immunochemical testing are:

  • Recommended for average risk colorectal cancer screening.
  • It is non-invasive.
  • It can be done in the privacy of your home.
  • It is affordable and usually covered by insurance.
  • No dietary or medication restrictions.
  • It is easy to use.
  • No preparation is required.




How is systematic screening done for colorectal cancer?


Systematic screening is done by using a combined screening model offecal immunochemical test (FIT) and colonoscopy made available through primary-care physician referral. It has been proven that a program that offers patients a fecal screening option is likely to have higher participation than a program that offers only colonoscopy.




What are the goals of colorectal cancer screening?


The goals of colorectal of cancer screening are:

  • Early diagnosis of cancer in the preclinical state
  • Down-staging of tumors
  • Increasing survival




What is the role of the primary care physician in decreasing the incidence of the onset of colorectal cancer in people younger than 45 years of age?


Incidence and mortality rate of colorectal cancer are increasing at a significant rate each year in individuals younger than 45 years of age. Primary care physicians have an important role to play in decreasing the incidence and mortality rate of colorectal cancer among younger individuals. They can change their approach by evaluating and educating their younger patients.

  • They can use readily available tools to obtain a detailed family history of the patient younger than 45 years of age, to assess each patient’s colorectal cancer risks. They can recommend earlier screening to those who meet high-risk family or personal history criteria.
  • Genetic counselors can assess patients with suspected high-risk hereditary syndromes. Patients with a confirmed hereditary syndrome can be directed to appropriate screening protocols, prophylactic operations, and other risk modification strategies.
  • They could improve detection of colorectal cancer in younger individuals by spreading awareness that colorectal cancer most often occurs in individuals with no family history or apparent risk factors and is increasing among individuals younger than 45 years of age.




How can I prevent colorectal cancer?


You can prevent colorectal cancer by choosing a healthy lifestyle and doing the following:

  • Get regular screenings for colorectal cancer
  • Eat lots of vegetables, fruits, and whole grains
  • Get regular exercise
  • Watch your weight
  • Avoid smoking
  • Limit alcohol





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