Colon cancer screenings — important but often ignored

On I-95 at mile marker 158 in the County of Prince William, motorists can expect potential delays due to a vehicle accident. The north right shoulder is closed.

Trying to get Americans to take their medicine isn’t always easy. Getting them to have a colonoscopy to detect colon cancer is ever harder. But researchers say they have recently discovered that money can be an effective incentive.

In fact, offering a financial incentive to eligible patients more than doubled the rate of preventive colonoscopy screenings compared to an emailed request. This information is especially important because although screening colonoscopies increase the likelihood of earlier detecting and preventing colon cancer, tens of millions of Americans don’t receive them when they should.

The study, which was conducted by the Perelman School of Medicine at the University of Pennsylvania, included 2,245 adults aged 50 to 64 years old. The patients were split into three different groups, and the group that received the financial incentive had the highest percentage of patients who got screening colonoscopies.

Typically, a colonoscopy can be “challenging for patients, requiring a day off from work, a bowel cleansing preparation, and transportation, in addition to non-financial costs of anxiety and discomfort,” according to lead author Shivan J. Mehta, MD. But because the increase in rate of screening colonoscopies was statistically significant, he believes that the financial incentive could contribute to improving that rate.

Colon cancer second-leading cause of cancer death

Why is a screening colonoscopy so important? The U.S. Preventive Services Task Force recommends screening for colorectal cancer beginning at age 50 and continuing until 75 years old because it is the second-leading cause of cancer death in the United States. Among other screening strategies, the Task Force recommends screening every 10 years with a colonoscopy.

What is colorectal cancer, though? It is a cancer that begins in either the colon or the rectum, but they’re often grouped together because they have similar features. Most colorectal cancers start as a polyp, or a growth on the mucosal lining of the colon or rectum. There are two major types of polyps:

  • Adenomatous (adenomas): they may become cancerous (i.e. pre-cancerous); and
  • Hyperplastic and inflammatory: more common, but generally not pre-cancerous.

The polyp forms on the innermost layer of your colon or rectum, but it can spread to other layers and even to other parts of your body if it reaches your lymphatic system.

There is no specific cause of colorectal cancer, but there are some risk factors that can make you more prone to develop it. Some factors are modifiable, which means you can change them:

  • Being overweight or obese;
  • Physical inactivity;
  • Diets high in red meats and processed meats;
  • Smoking; and
  • Heavy alcohol use.

These are risk factors that you can’t change:

  • Being older;
  • Having a personal history of colorectal polyps or cancer;
  • Having a personal history of Inflammatory Bowel Disease (IBD);
  • Having a family history of colorectal cancer or adenomatous polyps;
  • Having an inherited family cancer syndrome (specific gene mutations that increase your chance of getting the disease);
  • Being an African American or of Ashkenazi Jewish descent; and
  • Having Type 2 Diabetes.

It’s unclear what effect these risk factors have:

  • Doing night shift work; and
  • Receiving previous treatment for testicular or prostate cancer.

Common colon cancer symptoms

If you think you might have colorectal cancer, some symptoms are:

  • Diarrhea or constipation;
  • Feeling like your bowel isn’t completely emptying;
  • Bright red or very dark blood in your stool;
  • Narrower stools than usual;
  • Frequent gas pains or cramps;
  • Feeling full or bloated;
  • Unexplained weight loss;
  • Fatigue; and
  • Nausea or vomiting.

There is no way to prevent colorectal cancer, but you can follow the U.S. Preventive Task Force’s guidelines and possibly receive early detection through recommended screening. Based on your family history and your personal medical history, you should work with your healthcare professional to customize your screenings.

If you are diagnosed with colorectal cancer, there are six types of standard treatment:

  • Surgery;
  • Radiofrequency ablation;
  • Cryosurgery;
  • Radiation therapy;
  • Targeted therapy; and
  • Chemotherapy:
    • Colon cancer medications (i.e. Avastin, Camptosar, Lonsurf, Stivarga, Vectibix, Wellcovorin, Xeloda, Zaltrap); and
    • Rectal cancer medications (i.e. Avastin, Camptosar, Cyramza, Eloxatin, Erbitux, Lonsurf, Stivarga, Vectibix, Wellcovorin, Xeloda, Zaltrap).

Patients also have the option of participating in a clinical trial at any point during their treatment.