Reducing the Risk of Colorectal Cancer

Posted March 22, 2018 by Costas H. Kefalas, M.D., MMM, FACP, FACG, FASGE, AGAF

March is Colorectal Cancer Awareness Month. Colorectal cancer remains the #3 cancer killer in the U.S., yet it is one of the most preventable types of cancer. Statistically, 1 in 22 men and 1 in 24 women will develop colorectal cancer in their lifetime. According to the American Cancer Society, in 2018 more than 140,000 people will be diagnosed with colorectal cancer and 50,000 of them are expected to die of this disease. Colorectal cancer screening could save more than half of them. 

Although great progress has been made, we are not yet meeting colorectal cancer screening goals as a nation. Ohio ranks #31 out of the 50 states for screening people for colorectal cancer age 45 or older. The Ohio colorectal cancer screening rate is only 66%. 

Regular screening for and removal of colon polyps can reduce the risk of developing colorectal cancer. Colonoscopy with polyp removal can also reduce the number of deaths from colorectal cancer, as much as 53% according to the national polyp study published in the New England Journal of Medicine in 2012. The American Cancer Society recommends a colonoscopy every 10 years for average-risk individuals starting at age 45, and age 40 for those with a family history.  

Colonoscopy is considered the best test for colorectal cancer screening because it not only identifies precancerous lesions or polyps, but it also allows for their removal during the same procedure. However, the best test for colorectal cancer screening is the one that actually gets done. There are alternatives to colonoscopy. These include testing the stool for occult or hidden blood, with a fecal immunochemical test or FIT and a stool DNA test called Cologuard, to name only two.

The National Colorectal Cancer Roundtable began an initiative in 2014 with the goal of screening 80% of all Americans age 45 and older for colorectal cancer by 2018. The reason for this initiative was that screening rates had reached a plateau; too many people were not getting screened and were developing preventable colorectal cancer.

Today, because of the 80% by 2018 initiative, colorectal cancer screening rates have significantly increased. Although this initiative will conclude on December 31, 2018, the work to screen all Americans age 45 and older will continue beyond this date. It must continue because colorectal cancer is one of the most preventable cancers through screening. The 80% by 2018 initiative has put in place significant resources and infrastructure and has also raised awareness so that this work will not end this year.

When we think about all of the ways by which we can improve screening rates for colorectal cancer, we must also consider removing existing barriers. One such barrier is the issue of co-insurance when patients present for a screening colonoscopy and a colon polyp is found and removed. Often, patients are left with a co-insurance payment for a screening procedure that should be covered.  In my work with professional gastroenterology societies and digestive disease advocacy groups, I have had the privilege of traveling to Washington, D.C., and advocating on behalf of our patients for colorectal cancer screening. Earlier this month I was on Capitol Hill advocating with the Digestive Disease National Coalition for a bill that addresses this co-insurance issue (the Removing Barriers to Colorectal Cancer Screening Act).

Colorectal cancer is mostly preventable. If you have not yet had your own colorectal cancer screening test, please consider doing so; it may save your life.

Get the colonoscopy that could save your life! 

Get the to right colorectal screening test that could save your life! To schedule an appointment with a Summa Health specialist, call 234.867.6076 or visit summahealth.org/colon to learn more.