By Tonia W. Hale, DNP, MAOM, BSN, RN
The importance of routine health screenings can’t be overemphasized. Tests like mammograms and PSA exams for prostate cancer have the ability to detect cancers at their earliest stages, when no symptoms are apparent, and as we know, the earlier you can find cancer, the better a patient’s outlook is.
In terms of risk factors for any type of cancer, there are those you can control and those you can’t. Lifestyle changes that lower your risk for colorectal cancer include eating a healthy diet filled with fruits, vegetables, lean proteins and whole grains as opposed to processed, fatty foods and a lot of red meat, exercising daily instead of maintaining a sedentary lifestyle, refraining from using tobacco and avoiding excessive alcohol consumption. Your eating, drinking and exercise habits impact your weight, too, and staying in a normal weight range should be the goal, since obesity is linked to a higher risk of colorectal cancer.
Colorectal cancer risks that aren’t modifiable include having a family history of colorectal cancer and having a history of polyps yourself. Some populations are more prone to colorectal cancer as well, like African Americans and Ashkenazi Jews. Simply getting older also increases your risk.
In terms of prevention, there are now more screening tools available, but the best and most comprehensive screening is the colonoscopy, which average risk individuals should start having at age 50. For some patients, fecal occult blood testing is appropriate. This is a test that detects hidden blood in the stool. Though it can present evidence of colon cancer, it also indicates if you have many other conditions, such as hemorrhoids, ulcerative colitis and Crohn’s disease. Cologuard® is a test for those older than 50 who are at average risk for colorectal cancer. It not only looks for blood in the stool, it also hunts for DNA that has been altered by colon cancer or precancerous polyps. Your physician prescribes the Cologuard test and it is mailed to you. You perform the test at home, which involves taking a stool sample, using an agent to preserve it, and sending it to the lab, where it is analyzed. The results are sent to your doctor and if they come back positive, they will recommend that you get a colonoscopy. If your results are negative, your doctor may decide you don’t need a colonoscopy at this juncture.
Even though people joke about the fact that colonoscopies, and the preparation that precedes them, is something they dread, this screening is the most comprehensive test you can get. The colonoscopy also has the ability to transform from screening test to real-time treatment. If the physician performing the colonoscopy spots a polyp, they can remove it then and there, and you are advised to be screened more frequently than those whose colonoscopy results are normal. If no abnormalities are found, you don’t have to get retested for 10 years, but if polyps are found and removed, your doctor decides when your next screening should be, based on the pathology of the polyp or polyps that were removed and your other risk factors.
Something to be aware of is that even though your colorectal cancer risk goes up as you advance in years, an alarming trend started in the 1990s, and colorectal cancer diagnoses in younger adults under age 50 have more than doubled. Many studies are going on to research possible causes, including whether environmental factors may play a role, but definitive answers continue to elude researchers.
The good news is that colorectal cancer is treatable, and that the 5-year survival rate when it is caught early is 90 percent. This is why it’s important to speak with your primary care physician about when and how you should be screened, depending on what your individual risk factors are.
Commit to take good care of yourself in 2021, and place a conversation about getting screened for colorectal cancer with your doctor at the top of your to-do list.
Tonia W. Hale, DNP, MAOM, BSN, RN, is Chief Executive Officer and Chief Nursing Officer of Blue Ridge Regional Hospital in Spruce Pine.