Gastroenterology and Colon Cancer Screening: When to Start and What to Choose

Gastroenterology and Colon Cancer Screening: When to Start and What to Choose

Colon cancer is one of the most common and preventable cancers in the United States. The good news is that with the right screening, it is highly treatable. At Bergen Medical Associates in New Jersey, our gastroenterology team is here to guide you through every step of the colon cancer screening process. Here, we’ll help you understand your options and what to expect on the day of your procedure.

Key Takeaways

• Colon cancer screening saves lives, and most cases are preventable with early detection.
• Most people should begin screening at age 45.
• Several screening options are available.
• If you have symptoms, a family history of colon cancer, and haven’t been screened yet, now is the time to act.

Why Does Colon Cancer Screening Matter?

Colorectal cancer, cancer affecting the colon or rectum, is the second leading cause of cancer-related death in the United States. Yet it is also one of the most preventable cancers.

Modern colorectal cancer screening methods are effective because of how the disease develops. Colon cancer almost always begins as a small, non-cancerous growth called a polyp on the inner lining of the large intestine. Over time, some of these polyps slowly transform into cancer. When a gastroenterologist finds and removes a polyp early, the cancer never forms at all. Additionally, when an existing cancer is caught at an early stage, the five-year survival rate exceeds 90%.

When Should I Start Colon Cancer Screening?

Until recently, most guidelines recommended starting colon cancer screening at age 50. However, that shifted to age 45 due to a notable rise in colorectal cancer diagnoses among younger adults. If you’re 45 or older and haven’t been screened yet, speak to your doctor as soon as possible.

Earlier screening is recommended if you have:

• A parent, sibling, or child diagnosed with colon cancer or advanced polyps, especially before age 60 (screening will typically begin at age 40, or 10 years before the earliest diagnosis in your family)
• A personal history of inflammatory bowel disease (IBD), Crohn’s disease, or ulcerative colitis
• Lynch syndrome or familial adenomatous polyposis (FAP), which can require screening as early as the teens or twenties
• Other risk factors, such as a diet high in processed or red meat, obesity, being a smoker, or using alcohol heavily

Race also plays a role. Statistically, Black Americans have a higher incidence of colorectal cancer and are more likely to be diagnosed at later stages, which is why earlier screening is important. Because these risk factors aren’t always obvious, you need to talk to your gastroenterologist about your complete family and personal health history. They’ll tailor a screening plan to meet your needs.

Colon Cancer Screening Options Compared

There is more than one way to screen for colon cancer. The right choice for you depends on your health, preferences, risk level, and what your doctor recommends. Options include:

Colonoscopy

A colonoscopy is considered the gold standard. Colonoscopy detects colon polyps of all sizes more frequently and reliably than other screening tests. Additionally, colonoscopy is the only screening test that allows for polyp removal if indeed a polyp is detected. During this procedure, a gastroenterologist uses a thin, flexible scope with a camera to examine the entire lining of the colon and rectum. For average-risk patients with normal results, a colonoscopy only needs to be repeated every 10 years.  Colonoscopy requires a bowel preparation the day before and sedation during the procedure.

Stool-Based Tests

For patients who prefer non-invasive options, stool-based tests are an alternative. While stool-based tests do not require bowel preparation and sedation, they are not as effective as colonoscopy at detecting cancer and polyps. Additionally, there is the possibility of a false positive result, which can lead to anxiety and further testing. These tests detect signs of cancer or precancerous changes in stool samples. The most common types are:

• Fecal Immunochemical Test (FIT), an annual test that checks for hidden blood in the stool
• FIT-DNA test, such as Cologuard, which combines blood detection with analysis of abnormal DNA shed by colon cells, and is done every one to three years
• Guaiac Fecal Occult Blood Test (gFOBT), which is an older blood-detection method done annually

It’s important to keep in mind that a positive stool test always requires a follow-up with a colonoscopy.

Computed Tomography (CT) Colonography and Other Options

A CT colonography, or virtual colonoscopy, uses advanced imaging to generate detailed pictures of the colon without a scope. It requires the same bowel preparation as a traditional colonoscopy, and any suspicious findings will lead to a follow-up colonoscopy. When results are normal, doctors usually recommend a repeat test in five years.

Flexible sigmoidoscopy is another option, though it examines only the lower portion of the colon. It’s sometimes used every five years in combination with annual FIT testing.

When Should I See a GI Specialist?

Regular screening prevents colon and rectal cancer. However, you should talk to your doctor if you’re experiencing any of these symptoms:

• Blood in your stool or unexplained rectal bleeding
• A change in bowel habits that continues for more than a few weeks
• Abdominal pain, cramping, or bloating that doesn’t go away
• Unexplained weight loss or ongoing fatigue
• A persistent sensation that your bowel hasn’t fully emptied

These symptoms don’t automatically mean cancer; many have other explanations. A GI specialist can help assess your symptoms and recommend treatment or screening options.

Find Compassionate Color Cancer Screening Near You in New Jersey

At Bergen Medical Associates, our board-certified gastroenterologists take time with every patient. We explain your options, answer your questions honestly, and help you choose an approach that makes sense for your health and your life. From your first consultation through your procedure, our team is with you every step of the way. We have locations in Emerson, Montvale, Northvale, Paramus, and Ridgewood, NJ, making it easy to find treatment near you. To learn more or to begin treatment, request an appointment today.

Frequently Asked Questions About Colon Cancer Screening

Can I do a stool test instead of a colonoscopy?

For most average-risk adults, yes. However, any abnormal result will require a follow-up colonoscopy. If you have a family history of colon cancer, prior polyps, or active symptoms, a colonoscopy is the most appropriate starting point.

What if polyps are found in my colon?

Most polyps are benign and can be removed during the colonoscopy. After removal, the tissue is sent to a lab to determine the polyp type.

How often do I need colon cancer screening?

For average-risk adults with a normal colonoscopy, the standard interval is 10 years, beginning at age 45. If you’ve had polyps removed, you’ll need more frequent follow-ups.