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Screening the key to preventing colorectal cancer

Jessie Surla, DNP

Copyright © 2021 Roswell Daily Record

March is colorectal cancer awareness month and here at Eastern New Mexico Medical Center we are urging the communities we serve to not assume that colorectal cancer will not affect you.

Colorectal cancer is the second leading cause of cancer death in the United States and is affecting many individuals outside the “typical disease profile.” Colorectal cancer is third most commonly diagnosed cancer and affects both men and women equally — especially when it comes to mortality. Each year approximately 140,000 people are diagnosed with colorectal cancer and more than 50,000 people die each year.

But a bright spot in this is that colorectal cancer is preventive and the five-year survival rate is more than 90 percent when found at a local stage, meaning if you get screened and the polyps or precancerous lesions are found early.

However when compared to those lesions found with advanced stages the survival rate dropped to 14 percent in the same five years.

The key to preventing colorectal cancer is screening. The American Cancer Society within the last year recommended a reduction in the screening age to 45, however this still continues to be a challenge as insurance companies have not adjusted to this new standard of care. Prior to this the screening age was 50, except for African American populations, it was 45.

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These numbers can all be very confusing because it is also affected by your family history. If someone in her family had colorectal cancer, your screening should started age 40, or it should start 10 years prior to the age of diagnosis. This means that if you had a family member that was diagnosed with colorectal cancer at 35, you would start your screenings at 25.

This topic becomes more complex when you discuss genetic-based diseases like Lynch syndrome and familial polyposis syndrome (FAP), in which individuals should start screening at a very young age — typically prior to age 18.

For individuals that have a family history of a genetically-based colorectal cancer disease, genetic testing should be performed to establish if the individual carries the genetic marker so preventative screening can be implemented.

The Colorectal Cancer Alliance has started a media campaign entitled “Don’t Assume.”

The goal of the campaign is to provide education, reduce the stigma surrounding colonoscopies, and encourage patients to not ignore symptoms but rather talk to your provider. Providers often hear, “I am too young for that,” however research is showing us that colorectal cancer rates are increasing in the population under the age of 50.

Warning signs of colon cancer can include unexplained weight loss, rectal bleeding, changes in bowel activity and abdominal pain. If you are experiencing any of these symptoms talk to your primary provider about what steps to take next — remember “Don’t Assume.”

The gold standard for colorectal screening is a colonoscopy, however there additional screening tools that can be used, but do not ultimately exclude the need for colonoscopy. The additional screening tests include fecal occult blood testing, which tests for the presence of blood in stool, DNA-based testing which looks for markers released by tumors and polyps, and radiology-based tests. The additional screening tools are not meant to eliminate colonoscopies, however, each of the above tests can provide additional information, but ultimately do not exclude the presence of polyps or precancerous lesions.

Jessie Surla is a doctor of nursing practice for Eastern New Mexico Medical Group Gastroenterology Specialists. The advice offered in this column is that of the author.

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