The Best Screening Test is One that Gets Done!

May 05, 2015

These are the facts:

  • Colon cancer affects both men and women and all racial and ethnic groups.
  • Colon cancer is the second leading cancer killer in the U.S.
  • Early screening and detection saves lives.
  • Colon cancer almost always develops from precancerous polyps (abnormal growths in the rectum.

Early screening can find these polyps which can then be removed before they become cancerous.               

Early detection of colon cancer can save years of life.

 There are three main screening tests for colon cancer. They are:

High-sensitivity FOBT or FIT: FOBT stands for Fecal Occult Blood Test and FIT stands for Fecal Immunochemical test. After obtaining a kit from the doctor, this test can be done at home.

Flexible sigmoidoscopy-This test uses a small, thin, flexible, lighted tube to examine the rectum.

Colonoscopy-This test uses a longer tube than the flexible sigmoidoscopy. Doctors can remove most polyps and some cancers during this test.

 Most health care providers will recommend a colonoscopy for persons age 50 and over. Some people will heed this advice and schedule an appointment. But many ignore the recommendation (for a variety of reasons.) If this sounds like you, ask your doctor for the High-sensitivity FOBT or FIT. These screening tests are a starting point and will provide you with basic information.    

 Read this story, adapted from a blog by Marcus Plescia, MD, MPH, Former Director of CDC’s Division of Cancer Prevention andControl: Last year I turned 50. Time to get tested for colorectal (colon) cancer! As a physician, I’ve taken care of people who’ve had colon cancer; it’s serious. As director of CDC’s Division of Cancer Prevention and Control, I lead a national program that promotes colorectal cancer screening. If ever there was a time to step up to the plate, this was it. I told myself, ‘It’s time to practice what you preach!’ I took a good hard look at each test.  I understand the science, have good insurance, and can get any test I want. For some time now, I’ve tried to make the argument that colonoscopy is not the only colon cancer screening test option. And if I could do anything to help people understand that there are effective test options, I would. There is appeal to the argument that with colonoscopy, you can see the inside lining of the colon, so it can be a very thorough checkup, with polyp removal if necessary. But the FIT has advantages, too. I opted for the FIT because it was a very reasonable option, one I’m comfortable with. It met my needs perfectly. I wanted to lead by example—it’s one thing to say that it’s a very effective colorectal cancer screening test and recommend it to others … another to do it yourself. But that’s not the only reason I chose FIT. I also thought, ‘Boy, this is pretty easy!’ I got the test in the mail, it took about five minutes, nothing unpleasant about it, and I sent it back. I liked having options, and that I could tailor what test I did to what my preferences were. I liked the idea that it was convenient, and that I didn’t have to take a day off of work. I’m due for my next FIT in April, and I’ll continue to think about and consider the test options every time I’m due for screening. At some point I may get a colonoscopy, though probably not for a while. I really believe what we say: the best screening test is the one that gets done!

  Depending on the results of the screening test or based on your family history and symptoms, you may still need a colonoscopy. While you may still feel some reluctance, these personal stories, adapted from the Centers for Disease Control website, may help you to see the value :

 Denise, Ohatchee, Alabama …a screening colonoscopy saved my life. For two years my doctor kept reminding me that I needed to have a screening colonoscopy. I was perfectly healthy and had no family history of colon cancer. I had many reasons to procrastinate, but basically, out of fear of the test, the prep, and a few dozen lame excuses, I chose to ignore my doctor. It wasn’t until my husband dared me in front of my doctor that I agreed to the test. To make a long story short, at the age of 52, I was diagnosed with rectal cancer. My fear of colonoscopies was nothing compared to my fear of dying from colorectal cancer! I was fortunate. My cancer was in the early stages, and surgery offered me a cure. The prep for the colonoscopy was honestly not that bad. The colonoscopy was accompanied by sedation that made me wonder, “Is that all there is to it?” The moral of my story is if I had waited until I had symptoms, it would have been too late.

 Joyce, Washington, D.C. In 1992, my husband and sister were diagnosed with colon cancer. They died within four months of each other. He had just turned 60 and my sister was 63. My husband had been in very good health, exercised religiously, ate a healthy diet, and got regular physicals by his internist. However, he did not get a colonoscopy. My sister was afraid of going to the doctor and did not want to get a colonoscopy. They both died unnecessarily. I get a colonoscopy regularly. I’m 71 and have had at least four of them. The first two times, I had polyps which were painlessly removed during the procedure. Do I enjoy the prep? No way. But I see it as a small price to pay for enjoying the rest of my life. The procedure itself has always been painless, and afterwards I have gone out with friends to a film or a walk, or gone back to work. I am passionate about people getting a colonoscopy. I check with my friends regularly to see if they are up-to-date on their exams. I don’t want to lose anyone else needlessly. (You can find more stories on the CDC website, keyword: colon cancer)

 If you decide to get a colonoscopy or if you need one following the results of a screening test, CT has a no-cost colon cancer screening program for persons who meet the criteria. It is called the CT Colorectal Cancer Control Program (CCRCP) and can be accessed on line. For more information on colon cancer, visit www.cdc.gov. For those without internet access, Quinnipiack Valley Health District residents (Bethany, Hamden, North Haven and Woodbridge) can email dculligan@qvhd.org or call 203 248-4528 for general information or for information on Connecticut’s program