Identifying & Combatting Colorectal Cancer

Colorectal Cancer is the second most common cancer. If diagnosed earlier, the cancer is curable with colonoscopy or surgical resection. However, once the tumor has spread to regional lymph nodes, liver or lung life expectancy is reduced.

Several options are available for colon cancer screening. The stool testing for guaiac has largely been replaced by fecal immunochemical tests. This offers a reasonably accurate and inexpensive screening test for colorectal cancer and advanced cancer. However, it may not be so accurate at detecting large polyps and early cancer.

Another stool testing option includes multitargeted stool DNA (Cologuard). This stool test is relatively new and is more sensitive than the FIT stool test. Additionally, the Cologuard stool exam is more expensive than the FIT exam.

Of course, Colonoscopy remains the most accurate screening test, and the only examination which can remove precancerous polyps and early cancer. With a normal colonoscopy in an average risk patient, repeat colonoscopy is not recommended for 10 years, and the risk of developing colon cancer is greatly diminished for 17 years.

If the patient is at risk risk for developing colon cancer, then colonoscopy is the preferred examination. Otherwise any option, including stool tests or colonoscopy, is acceptable. If the stool test is positive, then proceeding with a colonoscopy is necessary.

The Stool test requires repeating at frequent intervals whereas the colonoscopy is more sensitive and usually requires less frequent examinations. Most importantly, any of the above examinations are better than doing nothing. Consultation with a GI specialist who performs colonoscopies will help determine the best choice.

Daily Aspirin intake reduces the risk of colorectal cancer in high-risk Lynch Syndrome carriers. Lynch Syndrome is the most common hereditary cause of colon cancer; accounting for 5% of colorectal cancer.

In observational trials, daily Aspirin intake has been show to decrease Colorectal Cancer in average risk patients by 20-40%. These potential benefits of long-term therapy must be weighed against potential adverse effects including gastrointestinal bleeding and renal toxicity.

Consulting with a GI specialist will help determine whether this preventive therapy is advisable.