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Colon Cancer Prevention: You Have Options

by Hallie Anderson

April 2020

According to the North Dakota Colorectal Cancer Roundtable, the incidence of colon cancer is 6% higher in North Dakota compared to the rest of the nation. The organization suggested this might be due to lack of awareness about the modern testing that detects colon cancer in a precancer stage or an early stage – well before blood appears in the stool and changes in bowel movements occur, the signs of advanced colon cancer that is much more difficult to treat. Because only about 65% of eligible North Dakotans between the ages of 50 to 75 have been screened, in 2018, the Roundtable set a goal of raising that number to 80%.

Understanding the options for testing are one of the first steps in meeting the screening goal. Healthcare providers and their patients can choose between four available screening tests: three that involve direct examination of feces and the fourth that looks at the lining of the colon. Of the three tests that examine feces, two tests look for microscopic blood in feces and one looks for a cancer's DNA in cells released into feces.

The fecal occult blood test, or FOBT, has been available for many years. After three days of avoiding ibuprofen, aspirin, and red meat, a sample of the feces is placed onto a special card that is later processed to detect microscopic blood. Another test is the FIT test, or fecal immunochemical test. The FIT test is more specific for blood that comes from a precancer or cancer and not influenced by medication or food. Both the FOBT and FIT must be repeated every year for screening to be considered up to date. A newer third test looks for cancer DNA in feces and is called the FIT-DNA test. Depending on the advice of the healthcare provider, this test is repeated either yearly, or in two or three years.

If any of these three direct examinations of the feces are positive, the fourth test, the colonoscopy, is necessary to examine the colon itself.

Colonoscopy, a test that looks at the lining of colon, is the most commonly chosen option for colon cancer screening. A colonoscopy is a brief procedure that involves using a fiber-optic tube to examine the length of the large intestine. This test requires a “prep” to clean the colon of stool so the provider can see the colon wall clearly. An advantage of the colonoscopy is that if small precancerous or cancerous polyps are seen during the procedure, they can be removed.

People with normal colonoscopy results should have a colonoscopy done every 10 years to stay up to date with screening. If polyps are found to be precancerous or cancerous, or a person has a medical condition or family history raising colon cancer risks, this test might be recommended more frequently.

Because colon cancer is one of the few cancers that can actually be found early with screening, it's important for Stutsman County community members to talk with a provider about the screening that can save their life.

This article also appeared in the June 2, 2020 issue of the Jamestown Sun.

About the Author

Hallie Anderson is a third year medical student at the University of North Dakota School of Medicine & Health Sciences. She was selected as the Jamestown participant for the school's ROME program, or Rural Opportunities in Medical Education. The program includes teaching student doctors the importance of rural newspapers. As a future rural healthcare leader, Anderson has written this column to provide health information for her ROME community. The information is not for diagnosis or treatment and should not be used in place of previous medical advice provided by a licensed practitioner.