Remind Patients about Colorectal Cancer Screening

Results of a survey recently published in Cancer show that patient-physician discussion about colorectal cancer screening tests is the single strongest predictor of a patient getting screened.

Recently, free colorectal screenings were made available for pre-qualified, low-income adults at 10 sites across Massachusetts. The free screenings, now in their second year, were sponsored by the Mass. Department of Public Health in collaboration with the American Cancer Society (ACS) and the American Gastroenterological Assoc.

This year’s event was part of a larger, 10-state, free screening campaign for which Massachusetts was the model. The objective is to help educate the public about colorectal cancer and to reduce the relatively high incidence of colorectal cancer among low-income populations.

Early-stage colorectal cancer and the polyps that can progress to cancer are usually asymptomatic. Polyps detected at an early stage via colonoscopy can be removed before becoming cancerous, and if they are cancerous, they can be treated most easily and effectively if found early.

Dr. Carla Ginsburg, a gastroenterologist at Newton-Wellesley Hospital and an assistant clinical professor of Medicine at Harvard Medical School, noted that the most common barriers to colorectal screening are lack of awareness, lack of access, and embarrassment and anxiety about the test.

Ginsburg pointed out that there are several screening options available to patients. “Based on an individual’s risk from medical history and family history,” she said, “the appropriate approach to screening can be determined for each patient.”

The current ACS guidelines, developed in collaboration with the U.S. Multisociety Task Force on Colorectal Cancer, recommend that adults at average risk for developing colorectal cancer begin screening at age 50 using one of the following options for the early detection of cancer and adenomatous polyps:

  • Flexible sigmoidoscopy every five years;
  • Colonoscopy every 10 years;
  • Double-contrast barium enema ev-ery five years; and
  • Virtual colonoscopy every five years;

The recommendations also call for earlier and more frequent screening for the following groups:

  • Individuals with a personal history of colorectal cancer or adenomatous polyps;
  • People with a personal history of chronic inflammatory bowel disease; and
  • Those with a family history of colorectal cancer or polyps among a first-degree relative.

Robyn Alie writes about public-health issues for Vital Signs, the member publication of the Mass. Medical Society, where this article first appeared.