Colorectal cancer screening is highly effective in detecting and preventing colon and rectal cancers, the third leading cause of cancer death among men and women in the U.S., according to the U.S. Centers for Disease Control and Prevention (CDC). And yet, one-third of Americans, ages 50 and older, have not been screened.
“Screening saves lives and can prevent colon cancer,” said Susanne Shokoohi, MD, a gastroenterologist at Loyola Medicine and assistant professor at Loyola University Chicago Stritch School of Medicine. Colorectal death rates have declined over the past 15 years, due to better detection and treatment, despite the fact that “one out of three Americans is not meeting colorectal screening guidelines. In Illinois, the percentage of screened adults, age 50 and older, is just 64%.”
Dr. Shokoohi, who is featured in the video, Loyola Minute: Colon Cancer Awareness, highlights “5 Things to Know” about symptoms, risk factors, prevention and screening for colorectal cancer, which develops in the large intestine, or colon (the lower part of the body’s digestive system), and is diagnosed in more than 140,000 Americans each year.
1. All adults, beginning at age 50, should be screened for colorectal cancer. African Americans should begin screening at age 45, as they are at higher risk for colon cancer. The U.S. Preventive Services Task Force recommends that all adults, ages 50 to 75, be screened for colorectal cancer, a procedure that is covered by private insurance and Medicare. In addition to African Americans, adults with a familial history of colorectal cancer, a genetic predisposition for the disease, and/or a history of inflammatory bowel or Crohn’s disease, are at higher risk for colorectal cancer and should be screened earlier.
“Usually, when you turn 50, colorectal cancer screening is something your primary care doctor discusses with you,” says Dr. Shokoohi. “If you have higher risk factors, you usually start the conversation earlier. And of course if you have symptoms, talk to your doctor.”
2. A colonoscopy is the most effective method of detecting and preventing colon cancer. While there are several colorectal screening options, including in-home stool testing or a CT colonography, a colonoscopy—a minimally invasive procedure that allows medical staff to view your entire large intestine—is the most common and effective modality for the detection of cancer, and the detection and removal of any precancerous cell growth, or polyps.
“The goal is to remove the polyp before it becomes cancerous,” says Dr. Shokoohi. “If cancer is detected, we are often finding it at an early stage—before symptoms arise—allowing us to treat the disease more effectively.”
If no polyps or other irregularities are found, the procedure does not need to be repeated for another 10 years.
3. Colorectal cancer is rising among younger adults. While more than 90% of colorectal cancers are diagnosed in patients over age 50, a 2019 study found a small, but alarming rise in colorectal cancer rates in adults ages 20 to 40.
“We are seeing a jump in the 20 to 40 age group,” says Dr. Shokoohi. “And we’re not sure if the cause is genetics, obesity or diet. I would advise patients in this age group to not ignore any symptoms, and to talk to your doctor right away if any symptoms arise (see below).”
4. It’s important to know the symptoms of colorectal cancer. Adults, especially those with any risk factors, should be aware of the following symptoms for colorectal cancer:
- Rectal bleeding
- Any changes in bowel habits, such as constipation, loose stools or diarrhea
- Unintended weight loss
- Abdominal pain that is new or ongoing
- Weakness and loss of appetite
5. Diet and lifestyle choices can help prevent colorectal cancer. A diet high in fruits and vegetables, fiber and fish can prevent colorectal cancer, says Dr. Shokoohi, while the opposite – a diet high in processed meats, such as bacon, ham and hot dogs—is linked to a higher rate of colorectal cancer.
In addition, obesity, smoking, heavy alcohol use, and physical inactivity also are risk factors for colorectal cancer. The prevention of colorectal cancer is another reason “for people to get out and about and move,” says Dr. Shokoohi.
6. It’s easy to schedule a colonoscopy, and it’s never too late to have your first screening.
There are a variety of reasons that adults may not have yet scheduled a colonoscopy, says Dr. Shokoohi. “Their providers may not recommend it, people are getting lost in the system, or they’ve had multiple jobs” and inconsistent health insurance. “These adults should at least talk to their doctor about the benefits of colorectal cancer screening.
“A colonoscopy takes just one day in your life,” says Dr. Shokoohi, “and it can be lifesaving.”
7. Colonoscopies can be scheduled at Loyola Medicine by calling 888-584-7888. Loyola Medicine’s Digestive Health Program provides comprehensive, high-quality care in the diagnosis and treatment of diseases of the gastrointestinal system. Each year, the division performs about 8,500 procedures and conducts about 13,000 inpatient and outpatient visits. Loyola is ranked 33rd in the country in gastroenterology and GI surgery by U.S. News & World Report, which ranks nearly 5,000 hospitals.