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colorectal cancer earlier , at more treatable stages . The American Cancer Society , in 2018 , published updated guidelines with a recommendation to lower the starting age for CRC screening to 45 from 50 years of age , while the U . S . Preventive Services Task Force ( USPSTF ) maintained the 50-year age goal . 5 One advantage of initiating earlier screening is reducing risk of CRC due to earlier detection , which over time would , ultimately , reduce incidence in those age 50 and older . 6
The gold standard for CRC screening is a colonoscopy performed by a gastroenterologist every 10 years , or more frequently depending on findings . Non-invasive screening also exists and have been proven to reduce CRC deaths . 7 These include fecal immunochemical test ( FIT ) or guaiac-based fecal occult blood tests ( gFOBT ), which are collected at home and analyze blood in stool . 8 These should be performed yearly and positive testing on either of them should lead to further surveillance with colonoscopy . Other options exist such as stool DNA testing , CT colonography ( imaging modality ) and double-contrast barium studies . Despite the numerous modalities to screen for CRC , nearly one-third of the U . S . population is unscreened ; 6 therefore , it is important to tailor screening based on individual patient characteristics , preferences and medical history .
Health care providers play a pivotal role in guiding individuals towards lifestyle choices that can markedly lower their risk of colorectal cancer . Emphasizing the importance of a diet abundant in fiber , fruits and vegetables , while minimizing the consumption of red and processed meats , is paramount . Advocating for regular physical activity and discouraging tobacco use are equally important .
Colorectal Cancer Awareness Month serves as a timely reminder for medical providers to reinforce the importance of early detection through screening and to advocate for lifestyle modifications that mitigate the risk of colorectal cancer . By staying informed about the evolving landscape of CRC prevention and treatment , health care professionals can enhance their role as advocates for patient well-being and contribute to the ongoing efforts to reduce the burden of this prevalent malignancy .
References
1
Siegel RL , Miller KD , Jemal A . Cancer statistics , 2018 . CA Cancer J Clin . 2018 ; 68 ( 1 ): 7-30 .
2
Society AC . Colorectal Cancer Facts & Figures 2023-2025 . https :// www . cancer . org / content / dam / cancer-org / research / cancer-facts-and-statistics / colorectal-cancer-facts-and-figures / colorectal-cancer-facts-and-figures-2023 . pdf . Published 2023 . Accessed 1 / 31 / 2023 .
3
Siegel RL , Jemal A . Percentage of colorectal cancer diagnosed in adults aged younger than 50 years . Cancer . 2016 ; 122 ( 9 ): 1462-1463 .
4
Johnson CM , Wei C , Ensor JE , et al . Meta-analyses of colorectal cancer risk factors . Cancer Causes Control . 2013 ; 24 ( 6 ): 1207-1222 .
5
Wolf AMD , Fontham ETH , Church TR , et al . Colorectal cancer screening for average-risk adults : 2018 guideline update from the American Cancer Society . CA Cancer J Clin . 2018 ; 68 ( 4 ): 250-281 .
6
Shaukat A , Kahi CJ , Burke CA , Rabeneck L , Sauer BG , Rex DK . ACG Clinical Guidelines : Colorectal Cancer Screening 2021 . Am J Gastroenterol . 2021 ; 116 ( 3 ): 458-479 .
7
Ladabaum U , Dominitz JA , Kahi C , Schoen RE . Strategies for Colorectal Cancer Screening . Gastroenterology . 2020 ; 158 ( 2 ): 418-432 .
8
Society AC . Colorectal Cancer Screening Tests . https :// www . cancer . org / cancer / types / colon-rectal-cancer / detection-diagnosis-staging / screeningtests-used . html . Published 2020 . Accessed 1 / 31 / 2022 .
Dr . Alur is a University of Louisville School of Medicine graduate and second-year internal medicine resident at Loyola University Medical Center in Chicago , Illinois who is interested in gastroenterology .
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