What You Should Know About Colorectal Cancer Screening
According to the American Cancer Society, colorectal cancer is now the leading cause of cancer-related death among younger men and the second leading cause for women under 50, after breast cancer. In fact, more than 10% of new colorectal cancer cases are now occurring in people younger than 50.
The U.S. Preventive Services Task Force recommends that adults age 45 to 75 be screened for colorectal cancer, commonly called colon cancer. Screening can find precancerous polyps—abnormal growths in the colon or rectum—that can be removed before they become more serious.
Screening also helps find colorectal cancer at an early stage, when treatment works best. About nine out of every 10 people whose colorectal cancers are found early and treated appropriately are still alive five years later. Several screening tests can be used to find polyps or colorectal cancer, and the decision on which test to use on and what age to be screened should be made on an individual basis with your doctor:
Stool Tests
The guaiac-based fecal occult blood test (gFOBT) uses the chemical guaiac to detect blood in the stool. For this test, you receive a test kit from your healthcare provider. At home, you use a stick or brush to obtain a small amount of stool. You return the test kit to the doctor or a lab, where the stool samples are checked for the presence of blood. It is done once a year.
The fecal immunochemical test (FIT) uses antibodies to detect blood in the stool. It is done once a year.
The FIT-DNA test (also referred to as the stool DNA test) combines the FIT with a test that detects altered DNA in the stool. For this test, you collect an entire bowel movement and send it to a lab, where it is checked for altered DNA and for the presence of blood. It is done once every three years.
Flexible Sigmoidoscopy
For this test, the doctor puts a short, thin, flexible, lighted tube into your rectum. The doctor checks for polyps or cancer inside the rectum and lower third of the colon. It is done every 5 years, or every 10 years with a FIT every year.
Colonoscopy
This is similar to flexible sigmoidoscopy, except the doctor uses a longer, thin, flexible, lighted tube to check for polyps or cancer inside the rectum and the entire colon. During the test, the doctor can find and remove most polyps and some cancers. Colonoscopy also is used as a follow-up test if anything unusual is found during one of the other screening tests. It is done every 10 years for people who do not have an increased risk of colorectal cancer.
CT Colonography (Virtual Colonoscopy)
Computed tomography (CT) colonography, also called a virtual colonoscopy, uses X-rays and computers to produce images of the entire colon, which are displayed on a computer screen for the doctor to analyze. It is done every 5 years.
Knowing which test to use depends on several factors, including your personal preferences and medical condition; your personal or family history of colorectal cancer or colorectal polyps; if you have a genetic syndrome linked to colorectal cancer; the likelihood that you will get the test; and the resources available for testing and follow-up.
Each screening test has advantages and disadvantages. The most serious risks are primarily associated with the use of a colonoscopy. The harms are small but increase with age, primarily because the possible complications from colonoscopy (i.e., bleeding, infection or a hole in the intestine) increase with age. It’s best to talk to your doctor about the pros and cons of each test, as well as how often to be tested.
Finally, screenings also are beneficial for employers, who bear a huge portion of the medical costs associated with treating cancer. According to a 2023 survey published by the non-profit Business Group on Health, cancer became the top driver of large companies’ healthcare costs last year.
The survey showed that more than 13% of employers had seen more late-stage cancers in the workforce. And, rising rates of colorectal cancer are especially alarming, since it has the second-highest treatment cost of any type of cancer.
Colorectal cancer screening tests may be covered by your health insurance policy without a deductible or co-payment. You should also check with your insurance plan to find out what benefits are covered.
For more information about Medicare coverage, visit www.medicare.gov or call 1-800-MCEDICARE (1-800-633-4227). TTY users should call 1 (877) 486-2048.
Pacific Federal is a Zenith American company and subsidiary of Harbour Benefit Holdings, Inc.
