Did you miss your colorectal cancer screening this year because of the pandemic?  If so, we as nurse advocates are encouraging you to get that screening, if it is indicated.  Did you know that colorectal cancer is the second deadliest cancer in men and women combined?  But it is one of the most preventable, if you get your regular screenings.  Early detection of this type of cancer greatly reduces your chances of serious outcomes so it makes sense to keep up with this screening. 

Risk Factors

 You are considered at average risk for colorectal cancer if they don’t have:

  • A  history of colorectal cancer or polyps

  • A family history of colorectal cancer

  • A history of Crohn’s disease or ulcerative colitis

  • A history of getting radiation to the abdominal or pelvic area to treat a prior cancer

  • A hereditary colorectal cancer syndrome, such as familial adenomatous polyposis (FAP) or Lynch syndrome.

 

If you have any of the above risk factors that puts you into a high-risk category your screenings may start before age 45 and involve more frequent and specific testing.

 Don’t Ignore These Symptoms

If you have any changes in your digestive system or bowel habits such as:

  • Change in bowel habits like constipation or diarrhea

  • Blood in the stool

  • Change in shape or size of stool

  • Abdominal or rectal pain

  • Unexpected weight loss

  • Anemia

Updated 2021 Screening Guidelines

The U.S. Multi-Society Task Force recommends beginning screening at age 45 years in African American adults (weak recommendation) and screening at age 40 years (or 10 years before the age at diagnosis of a family member, whichever is earlier) in persons with a family history for colorectal cancer.

The American College of Gastroenterology updated its screening guidelines as summarized below:

  • Recommend colorectal cancer screening in average-risk individuals between age 45 and 75 years to reduce pre-cancerous growths called advanced adenomas, reduce colorectal cancer, and reduce death from colorectal cancer.

  • Suggest that a decision to continue screening beyond age 75 years be personalized.

  • Recommend colonoscopy and FIT(fecal immunochemical test) as the primary methods for colorectal cancer screening.

  • Suggest considering the following screening tests for individuals unable or unwilling to undergo a colonoscopy or FIT test: Flexible Sigmoidoscopy, Multi-target Stool DNA test, CT Colonography, or Colon Capsule.

Recommended Frequency for Different Screening Tests

The American College of Gastroenterology recommend the following tests as the primary screening methods for patients at average risk for colorectal cancer on this schedule:

  • Colonoscopy every ten years

  • FIT every one year

If one of these alternatives is used, they suggest that the tests be done on this schedule:

  • Multi-target stool DNA test every three years

  • Flexible sigmoidoscopy every 5 to1 0 years

  • CT colonography every five years

  • Colon Capsule every five years

They suggest against Septin9 (blood-based test) for colorectal cancer screening.

Screening for Patients with Family History of Colorectal Cancer or Polyps

  • If you have a family history of colon cancer, you may need to talk with your health care provider to see if an earlier and more frequent colonoscopy is required.

  • Sometimes, genetic testing may be required to determine your risk of colon cancer if you have a strong family history, especially with younger age of affected relatives.

Visit this website to take a screening quiz -  https://quiz.getscreened.org/

What’s New        

In honor of International Women’s Day on March 8th with the theme of courage, Northwell Health in New York did a press conference to speak of Anita Wolf, who is the first patient on the east coast to enroll in a clinical study on Pressurized Intra-peritoneal Aerosol Chemotherapy (PIPAC). 

PIPAC is a new way to deliver chemotherapy to patients with abdominal cancer who have very few options. It may be a new option for those with end-stage peritoneal cancer.  The chemotherapy is delivered in the form of a pressurized aerosol or spray. The procedure is done with a laparoscope requiring a few cuts and a nebulizer to directly inject the medication into the abdomen.   It is safe, and most people handle it well. Also, it has fewer side effects than regular chemotherapy.

Bottom Line

Don’t put this preventative screening at the bottom of your to-do list.  Make yourself and your health a priority. Follow the screening guidelines so that you prevent cancer or catch it early.

References

Shaukat, et al., American College of Gastroenterology Guideline on Colorectal Cancer Screening, The American Journal of Gastroenterology, March 2021 bit.ly/ACG2021-CRC-Guideline

https://www.facs.org/~/media/files/education/patient%20ed/colonoscopy.ashx

https://gi.org/patients/colorectal-cancer-awareness/