Over 50 years of age? Or perhaps you know someone over 50? Then you may want to read this article!
Nitty-Gritty: When colorectal cancer (CRC) is caught early, 9 out of 10 people can be cured. Routine CRC screening is generally performed for those between 50-74 years of age. Screening means checking for a disease even if you don’t show any symptoms of the disease. Screening can potentially save lives when cancer is detected early. The type of screening test you get depends on whether you are at average risk of getting colorectal cancer or at increased risk of getting colorectal cancer.
What does it mean to be at average risk for colorectal cancer? 🧐
You may be considered average risk if you are between 50-74 years of age and:
◦ You do not have a first-degree relative (sibling, parent or child) with a history of CRC.
◦ You do not have a personal history of precancerous colorectal polyps or inflammatory bowel disease (i.e., Crohn’s disease involving the colon, or ulcerative colitis).
If I am average risk, how is screening performed? 🧪
Fecal immunochemical test (FIT) is a common test which can be done at home. It tests a small amount of stool for blood. Blood in the stool can be caused by CRC or some precancerous polyps. The FIT is typically performed every 2 years for those at average risk. ⏱
If the FIT is abnormal, then guidelines recommend that a flexible sigmoidoscopy or colonoscopy is performed within 8 weeks of the receiving the abnormal result.
What is a flexible sigmoidoscopy? What is a colonoscopy? 💩
Flexible sigmoidoscopy [sig-moi-dos-kuh-pee ] and a colonoscopy [ koh-luh-nos-kuh-pee ] are very similar. They are both performed by inserting a flexible tube-like instrument that has a light and lens into the anus to view parts of the colon. They are performed every 5-10 years depending on your individual scenario.
During these procedures, the specialist can also remove tissue from the colon if needed, such as a polyp. Polyps can develop on the surface of bowel tissue and they can sometimes be cancerous. Our risk of developing polyps increases as we age.
How do I know if I am at increased risk? ⚠️
Someone is considered increased risk if they have 1 or more of the following:
◦ You have a family history of colorectal cancer that includes 1 or more first-degree relatives (parent, sibling or child) with colorectal cancer.
◦ You have a history of non-cancerous polyps
◦ You have inherited conditions, such as familial adenomatous polyposis (FAP) or Lynch syndrome (also called hereditary non-polyposis colorectal cancer, or HNPCC)
◦ You have inflammatory bowel disease (i.e., Crohn’s disease involving the colon, or ulcerative colitis).
Additionally, your healthcare provider may deem you increased risk for other reasons not stated above.
How am I screened if I am at increased risk?
For someone at increased risk due a family history of colorectal cancer, the guidelines recommend to start screening at age 50, or 10 years earlier than the age their relative was diagnosed with colorectal cancer, whichever comes first.
⏱️Generally, those who are at increased risk are screened every 5 years with colonoscopy.
If you notice any of the following warning signs, report them to your healthcare provider, no matter your age. ⛔️
◦ Change in bowel habits lasting a week or two, such as rectal bleeding, dark or narrow stools, constipation or diarrhea, abdominal cramps, or the urge to move your bowels when you don’t need to.
◦ Constant fatigue, anemia, and unexplained weight loss can also be signs associated with colorectal cancer.
What if I am younger than 50 years of age? 🐣
Generally, guidelines do not recommend regular screening for people younger than age 50 with no first-degree relative(s) who have been diagnosed with colorectal cancer.
However, there are things that all of us can do to lower our risk, whether it is average or increased. A balanced diet with a variety of fruits, vegetables and whole grains is beneficial. As well, limiting red meats and red wine 🥩🍷 can also help reduce your risk. A lifestyle that promotes routine exercise and a balanced diet of whole foods (i.e., low in processed foods) is likely to reduce one's risk for many types of cancers and other diseases.
It should also go without saying, being a non-smoker 🚭 further reduces your risk of colorectal and other types of cancers.
Big Picture 📸
Ultimately, every person's risk should be individually assessed by a licensed healthcare provider, such as a doctor or nurse practitioner. It is encouraged that you raise any concerns or questions related to your health and well-being with your family healthcare provider. After all, a collaborative relationship with your healthcare provider and screening promotes the chances of a healthy and long life.
Sources and additional resources:
Colorectal Cancer Canada
Choosing Wisely Canada is the national voice for reducing unnecessary tests and treatments in Canada. Additional Choosing Wisely Canada patient resources can be found here.
Colorectal Cancer Screening Recommendations Summary
Unfortunately, not everyone has access to a family healthcare provider, therefore, you are encouraged to contact your provincial cancer care program for further information about screening in your region. Some provinces have mobile screening clinics and other initiatives to provide screening to those without a family healthcare provider.
Québec Cancer Foundation
Cancer Care Ontario
BC Cancer
Alberta Colorectal Cancer Screening Program
Newfoundland & Labrador Colon Screening Program
Yukon Colon Cancer Screening Program
Northwest Territories Colon Cancer Screening Program
Prince Edward Island Colorectal Screening Program
Nova Scotia Colon Cancer Prevention Program
New Brunswick Colon Cancer Screening Program
Nunavut Colorectal Cancer Screening Program (Pilot Program)
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