Defying the odds: The power of prevention in colorectal cancer

Dr. Steven Nurkin interacts with a colleague in clinic

Colorectal cancer is the third most common cancer in the United States, but it is also one of the most preventable with screening.

By establishing regular screening methods, such as stool-based tests or colonoscopies, doctors can detect the disease at an early stage or even prevent it from occurring altogether by removing polyps. According to Steven Nurkin, MD, MS, FACS, Chief of Colorectal Surgery at Roswell Park Comprehensive Cancer Center, a colonoscopy is considered the "gold standard" screening test for colorectal cancer as it can identify early-stage cancers and remove polyps.

“According to the National Polyp Study, which included more than 10,000 people who had screening colonoscopies, when compared to the general population, those who had polyps removed during colonoscopy had a 53% reduction in dying from colorectal cancer over the next 15 years,” Dr. Nurkin says. Based on this and other similar studies, he emphasizes that having a colonoscopy with the removal of polyps can prevent cancer and save lives.

Colorectal cancer risk factors and screening options

For those who may feel uncomfortable with prepping for or scheduling a colonoscopy, stool-based tests like Cologuard (checking DNA in the stool) or fecal occult blood exams may be an alternative, but these tests are not recommended for people with certain medical problems, such as inflammatory bowel disease, a significant personal or family history of polyps or cancer, or a hereditary syndrome that results in polyps in the colon.

“The best screening test is the one that gets done,” Dr. Nurkin says. “Cologuard is recommended for average-risk individuals. We recommend you reach out to your primary care physician to see if you’re a candidate for those at-home tests.”

Also at elevated risk for developing colorectal cancer are African Americans, many of whom live in medically underserved communities or who might have a greater hesitancy to get tested for this type of cancer. Additionally, African Americans are at higher risk of developing colorectal cancer at younger ages and to have a more advanced disease when diagnosed, yet the rate of screening in this community remains low. An estimated 90% of people who are diagnosed with colorectal cancer and die from the disease are 50 years and older, but in recent years, more people under the age of 50 are being diagnosed. These younger patients also are more likely have advanced stage disease, a trend that began in the mid-1980s.

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As a result of this troubling trend, screening guidelines were recently revised to lower the age to start screening to 45. Smoking, alcohol abuse, a less-active lifestyle, diets high in red or processed meats, and hereditary factors all contribute to a person’s risk of developing colorectal cancer. Experts are not sure why the rates are increasing among younger adults; it is therefore crucial to pay attention to new symptoms and know your body and risk factors.

"If you're experiencing persistent symptoms such as rectal bleeding or irregular bowel movements that last beyond a few weeks, it's crucial to seek medical attention," Dr. Nurkin emphasizes. "It's important to be in tune with your body and recognize when things aren't normal. Contact your primary care doctor for guidance and advice."

Dr. Nurkin emphasizes the significance of understanding one's family history and its role in cancer risk. "In addition to being aware of your personal medical history, it's essential to inquire about your family's medical history. It's important to reach out to your relatives, especially immediate family members, and ask these questions to assess your risk for cancer."

Early colorectal cancer detection saves lives

By being proactive and informed about your health and family history, you can take steps to prevent and detect colorectal cancer early on, improving your chances of successful treatment and long-term survival.

Dr. Nurkin adds that, when caught early, colorectal cancer can be prevented or treated effectively. Regular screenings and early detection testing, such as colonoscopies or stool-based tests, are essential for catching the disease early. It is crucial to be an advocate for your health and wellness. Please reach out to your primary care physician to determine if you are a candidate for screening and which test is best for you.