Colon Cancer: Second-Leading Cause of Cancer Deaths

Colorectal cancer is the second leading cause of cancer deaths in the United States. Many of these deaths could be prevented with early detection, according to Dr. Allen Perkins, a family medicine physician with USA Physicians Group and chair of USA College of Medicine’s Family Medicine Department.

An appropriate colorectal cancer screening is the only way to accurately detect the cancer in its earliest stages,” said Dr. Perkins. “Because symptoms typically do not occur during the earlier stages, many people who do not receive regular screenings aren’t diagnosed until the disease has progressed.”

Screening tests recommended by the U.S. Preventive Services Task Force include colonoscopy, flexible sigmoidoscopy, high sensitivity fecal occult blood test (FOBT) or the new fecal immunochemical test.

The fecal immunochemical test (FIT) is a noninvasive screening test recommended for average risk persons that detects hidden blood in the stool. This detection is important because it can be a sign of precancerous polyps or colon cancer. The FIT is similar to a fecal occult blood test (FOBT), except that the FIT doesn’t require patients to follow a restricted diet before taking the test.

Dr. Perkins said the FIT test is done by placing stool in a collection container at home and sending it in to be developed.

“The FIT screening is only for those people of average risk, meaning those over 50 years of age with no history of adenomas, colorectal cancer, or inflammatory bowel disease, and for those without a strong family history of colorectal cancer,” Dr. Perkins said. “People who are at significant risk – such as those with a strong family history of colon cancer, certain diseases such as ulcerative colitis, and a previous history of colon pre-cancer – should seek advice from their physician about how often and when to start screening.”

According to Dr. Perkins, patients who are at significant risk typically require a colonoscopy.

Dr. Perkins said the FIT test has been proven to save lives. “It is seen to be as good as colonoscopy in that regard,” he said. “One disadvantage of the FIT is that it will not find nearly as many small pre-cancers as a colonoscopy. As a result, the FIT must be done frequently – most think annually – to be effective.

For those who are between the ages of 50 and 75, a colonoscopy every decade or a test for blood in the stool every year provides protection from colon cancer.”