Colorectal cancer, also known as bowel cancer, colon cancer, or rectal cancer, is one of the most common cancers diagnosed in the United States. It develops from the inner lining of the colon or rectum and is treatable if caught early through screening. Colorectal cancer screening market can find precancerous polyps (abnormal growths) so they can be removed before turning into cancer. Screening also helps find colorectal cancer early when treatment works best. With appropriate screening, the risk of dying from colorectal cancer can be reduced significantly. This highlights the immense importance of regular screenings for colorectal cancer prevention and early detection.
Who Should Get Screened?
The US Preventive Services Task Force recommends that individuals between the ages of 45-75 years should be screened regularly for colorectal cancer. Some of the high-risk groups who should consider screening earlier or more often include:
- Individuals with a personal or family history of colorectal cancer or polyps. Those with a family history of colorectal cancer in a first-degree relative (parent, sibling, or child) before age 60 should start screening at age 40.
- Individuals with a personal history of inflammatory bowel disease like Crohn's disease or ulcerative colitis. Screening for these high-risk groups may need to start prior to age 45 and be done more frequently.
- Individuals with certain genetic syndromes like familial adenomatous polyposis or Lynch syndrome. People with these genetic risks need to consult with their doctors about specific screening guidelines.
Available Screening Options
There are a variety of screening options available for colorectal cancer which can be used depending on individual circumstances and doctor's recommendations:
- Colonoscopy
This test examines the entire colon and rectum using a colonoscope which is a thin, flexible tube with a camera and light at the tip. Polyps or tumors can be seen directly and removed during the procedure if found. This is considered the “gold standard” screening test as it allows detection and removal of precancerous lesions. It needs to be repeated every 10 years if results are normal.
- Flexible Sigmoidoscopy
Similar to colonoscopy but examines only the lower third of the colon using a sigmoidscope instead of a colonoscope. Polyps can be removed if found. Needs to be performed every 5 years along with annual fecal immunochemical tests.
- Fecal Immunochemical Test (FIT)
This non-invasive screening test detects hidden blood in the stool which could indicate polyps or cancer. A simple home test requires collecting a small stool sample annually. Positive results may warrant colonoscopy.
- Stool DNA Test
It examines stool samples for certain abnormal sections of DNA that may be present if precancerous or cancerous lesions are bleeding. This test needs to be done annually.
- CT Colonography (Virtual Colonoscopy)
This imaging test uses CT scanning to examine the colon and rectum. It doesn't allow removal of polyps but can detect cancers and growths larger than 5 mm that may need conventional colonoscopy for removal. Requires less preparation than colonoscopy.
Barriers to Screening
Despite the clear benefits, many who should be screened regularly do not follow screening guidelines. Some of the major barriers that prevent people from colorectal cancer screening include:
- Lack of awareness about risks and importance of screening
- Fear or embarrassment regarding the screening tests like colonoscopy
- Concerns about test preparation or procedure-related pain or discomfort
- Cost and insurance coverage issues
- Busy work schedules making it difficult to schedule and prepare for the screenings
- Lack of recommendation or reminder from healthcare providers about screening
It is important that awareness is raised in communities about colorectal cancer risks and available screening options. Healthcare systems should focus on lowering barriers by increasing insurance coverage, streamlining scheduling processes, and reminding patients well in advance of due screening date.
Improving Screening Participation Rates
There have been various national efforts towards improving suboptimal colorectal cancer screening rates in the US. The Centers for Disease Control and Prevention (CDC) launched the National Colorectal Cancer Roundtable in 1997 to bring together organizations committed to 80% screening rates by 2018. This target was unfortunately not achieved requiring continued efforts. New national goals have been set for 2030 now with a multi-pronged strategy:
- Increasing access to affordable screening through the Affordable Care Act provisions. This expanded insurance coverage has improved screening rates but more eligible individuals still need to utilize preventive services.
- Enhancing provider recommendations through quality improvement initiatives at healthcare organizations. Reminders and standing orders for screenings during visits increase screening discussion and completion rates.
- Using mass media campaigns to raise awareness in the general public and target populations. Campaigns like 80% by 2018 and Catch It Early conducted by the CDC and partners help improve knowledge and perception of screenings nationally.
- Involving community health workers, patient navigators, and social services to address barriers faced by underserved populations. Culturally appropriate programs help boost participation of minority groups.
- Promoting screening guideline changes in 2018 now recommending all adults between 45-75 years get screened regardless of family history or other risk factors. This simplified one-size-fits-all messaging aims at further screening normalization.
Coordinated implementation of evidence-based interventions at all levels shows promise to steadily increase the rates of colorectal cancer screening market and lower the burden of this largely preventable disease in the coming years. Wider community engagement will be key to realize full screening potential across the country.
Conclusion
In summary, colorectal cancer remains a major public health problem but can be prevented through regular screening which allows detection and removal of precancerous polyps before they turn cancerous. While screening tests may cause some discomfort or embarrassment, missing this opportunity for early detection poses a far greater health risk. Multiple safe and effective screening options exist to suit different needs and circumstances. With community-wide efforts towards raising awareness, addressing barriers, and promoting healthcare access, we can work towardsrecommended screening rates for all eligible individuals and reduce the impact of colorectal cancer significantly. Timely and regular cancer screenings really do save lives.
