If you are in good health and do not have a family history of colorectal cancer, the American Gastroenterological Association recommends annual stool screenings using a fecal occult blood test (FOBT) beginning at age 50. This test involves putting a small amount of stool on a specially treated card, which is then sent to a lab to check for traces of blood not detectable by the naked eye. This test has been credited with reducing deaths from colorectal cancer by one-third.
Next, it is vitally important to get a digital rectal examination, plus one or more of the following recommended tests: a sigmoidoscopy, double-contrast barium enema or a colonoscopy.
- A sigmoidoscopy is an examination of the lower third of the colon (where 60 percent of the cancers occur) using a flexible lighted instrument. This should be done once every five years.
- A double-contrast barium enema (recommended once every five years beginning at age 50) may be used for elderly patients or patients with heart disease. If abnormal, a colonoscopy is needed.
- Colonoscopy is one of our best weapons against colorectal cancer because it can both detect and prevent the disease. This test also involves using a flexible lighted instrument, but the advantage is that it examines a more extensive area of your colon, and should be done once every 10 years.
The type of test(s) you should get will be determined by your overall health, as well as by an in-depth discussion with your physician.
An important exception to the age 50 recommendation is if you or your family have a history of colorectal cancer or polyps, or if you or a loved one has a history of ulcerative colitis or Crohn's disease. If the answer is yes, then preventive health screenings will begin at age 40, or perhaps even earlier.
Over the past several years, I have known two wonderful physicians who didn't take the time to get checked for colorectal cancer. I can still picture both of them in their hospital beds. They were so vibrant just a year earlier attending to others in those very same beds. Unfortunately, both were diagnosed late in their disease and were lost from this life in their mid-50s. This didn't have to happen, because colorectal cancer has an enemy — early screening and treatment. We have it in our power to make the first move, and the time is now. For further information about this nasty disease, please call the American Cancer Society at 1-800-ACS-2345.
Copyright 2003, Dr. Rob Danoff
Robert Danoff, D.O., M.S., is a family physician. He is program director of Family Practice Residency Frankford Hospitals, Jefferson Health System, Philadelphia, Pa. He also is a medical correspondent for The Comcast Network, CN8, contributing writer to the New York Times and writes a weekly medical column for the Bucks Courier Times, Bucks County Pa.