How do you screen for colorectal cancer?

Incidents of colorectal cancer are rising in younger people. Know how to screen for it.

Early onset colon cancer is a growing problem, especially for age groups that historically haven’t had to worry about it.

In the next decade, it is estimated 25 percent of rectal cancers and 10 to 12 percent of colon cancers will be diagnosed in people younger than 50.

And early colon cancer doesn’t always have noticeable symptoms, meaning screening is important, especially if you are 45 years old or older.

There are several ways to test for colorectal cancer that are usually prescribed by your primary care provider.

C.P. Choudari, M.D., the medical director of Meritus Hagerstown Gastroenterology, said his experience shows there is a clear difference among the tests available.

“Colonoscopy is the gold standard,” said Dr. Choudari, who has been a practicing physician for more than four decades.

The visual exam uses a scope inserted into the rectum to examine the colon. It is the only test that not only screens for cancer, but also identifies and removes pre-cancerous polyps before they become malignant, Dr. Choudari said. And it correctly identifies 95 percent of patients with cancer.

The downside is that it is an invasive procedure. The patient prepares using strong laxatives for a few days before the procedure, and is usually sedated during the procedure. That can lead to lost time at work.

However, because the screening is so highly effective, Dr. Choudari said that anyone with a family history of colon cancer or personal history of polyps should opt for it.

Other tests, which aren’t invasive, rely on testing a person’s stool for evidence of cancer. Often, they can be performed at home.

Studies have shown that such tests correctly identify about 92 percent of patients with cancer, and correctly identify about 87 percent of patients who do not have colon cancer, he said.

However, his experience has shown an unacceptable number of false positives and false negatives with the tests. Also, the tests aren’t as effective as a colonoscopy at detecting pre-cancerous polyps, and it doesn’t remove them.

“These tests are designed to detect cancer, not prevent it,” he said.

With this in mind, Dr. Choudari and other gastroenterologists say stool-based colorectal tests should only be prescribed for patients at average risk for colorectal cancer.

“The major thing that I see as a gastroenterologist is people using stool-based tests when they shouldn’t be,” he said. “Because of their family history, or their personal history, they should be getting a colonoscopy.”

Things are beginning to get more urgent when it comes to colorectal cancer. Health officials recommend regular colon cancer screenings starting at age 45. The starting age just a few years ago was 50.

Anecdotally, Dr. Choudari said he encounters a colon cancer in a person under the age of 50 every two months or so while performing colonoscopies.

“We need to get patients and primary care providers to understand the facts, the pros and cons, and make a good decision,” he said.

To better meet patient needs when it comes to screening for colon cancer, Meritus Health recently opened the C.P. Choudari Surgical Center, which is named for Dr. Choudari. The center schedules colonoscopies and is in the process of certification for other procedures.

To learn more about colorectal cancer, visit www.meritushealth.com/ColorectalCancer or call 240-513-7072. To learn more about the C.P. Choudari Surgical Center, visit www.meritushealth.com/choudarisurgicalcenter.