Greater Harrisburg's Community Magazine

Screen Time: Colorectal cancer prevention–what you need to know.

Illustration by Brad Gebhart

Colorectal cancer is the second leading cause of cancer-related deaths for both men and women combined in the United States. However, the cure and even prevention of colorectal cancer is possible with the appropriate screening.

Unfortunately, only 60 percent of people actually get screened. Doctors, cancer organizations, and others are working to reduce the embarrassment and encourage open communication about colon and rectal health.

Can colorectal cancer be prevented?

Colorectal cancer usually develops from pre-cancerous polyps. Several screening tests detect these polyps including stool studies for blood and DNA, a flexible sigmoidoscopy and a colonoscopy.

Unlike other screenings, a colonoscopy allows your doctor to detect and remove pre-cancerous polyps at the same time.

Myth:  No one in my family has colorectal cancer so I am not at risk.

While it is true that a family history of colorectal cancer or colorectal polyps increases the risk, that is not the only risk factor. In fact, the majority of colorectal cancers discovered during a colonoscopy are found in people with no family history who are of average risk.

Myth:  I have no symptoms so my colon is fine.

Screenings exist to find the disease before you develop symptoms. Small colorectal polyps and early colorectal cancer produce no symptoms. Early detection of colon polyps or early colorectal cancers is the only way to prevent or cure colorectal cancer.

Once a cancer has grown to a size where it causes symptoms such as “bowel problems” or bleeding, the chance for a cure is greatly reduced.

Who needs to be screened for colorectal cancer?

  • Any patient with a positive screening test for colon cancer other than colonoscopy (i.e., Cologuard, FIT, etc.) must have a colonoscopy.
  • Men and women who have no symptoms and no family history of colorectal cancer should start screenings between the ages of 45 to 50. African Americans have a higher incidence of colon cancer and average risk screening should occur at age 45.
  • Adults of any age who have symptoms of abdominal or rectal pain, rectal bleeding, or a change in bowel habits should receive a screening.


Who needs to be screened before age 50?

  • Patients experiencing symptoms such as abdominal or rectal pain, bleeding, change in bowel habits.
  • Adults who have symptoms as described above or who have a family history. A family history is a first-degree relative (parent or sibling) who has had colorectal cancer or polyps.
  • Patients with a family history of colon or rectal cancer or polyps. In this case, you should be screened 10 years earlier than the age of the family member when he or she was diagnosed, or at age 40—whichever is younger.

While the incidence of colorectal cancer is declining in patients 50 years or older, there is a notable increase in patients younger than 50. Consequently, the American Cancer Society recommends screening all patients of average risk at age 45, but this is not uniformly accepted by all medical societies.

Will I ever need another colonoscopy?

  • A repeat colonoscopy is recommended every 10 years for patients without polyps who are of average risk.
  • High-risk patients with normal colonoscopies should have a follow-up screening every five years.
  • Patients found to have pre-cancerous polyps should typically have a repeat screening within three to five years of the polyp removal.


Other than screenings, what else should I do?

  • Know what’s normal for your body—track your bowel movements and abdominal symptoms.
  • Check your stool for signs of cancer. One of the biggest signs is rectal bleeding or blood in your stool.
  • Lifestyle changes reduce the risk of colorectal cancer and include:
  • Stopping smoking
  • Maintaining a healthy weight with an active lifestyle
  • Avoiding excessive consumption of alcohol or red and processed meat
  • Consuming a high-fiber diet, including whole grains, fruits and vegetables


What does a colonoscopy screening entail?

A colonoscopy is the single best screening exam for colorectal cancer.

colonoscopy examines the colon by using a long, flexible, lighted tube called the colonoscope, giving the doctor full view of the entire colon and rectum. During this same exam, the doctor can also remove pre-cancerous polyps.

The procedure itself takes about 45 minutes, and usually involves sedation. It’s rarely uncomfortable.


The prep for a colonoscopy

Patients switch to a clear-liquid diet the day before and use laxatives or a cleansing preparation to ensure the procedure is accurate. A colonoscopy is well worth any temporary discomfort to protect your health and your life.

To schedule a colonoscopy, talk to your primary care provider about when to schedule your first colonoscopy.

Jadd Koury, MD, FACS, FASCRS, is a physician with UPMC Pinnacle Colon and Rectal Surgery. For more information, visit

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