Maybe your grandmother had colon cancer. (This is cancer of the large intestine.) Or a friend just learned they have it. And you’re wondering, Could I get it, too?

It’s a good subject to bring up with your doctor. Colon cancer is the third most common cancer in the United States.¹ And the causes aren’t always known.

That’s why getting screened is important. Screening tests can help catch cancer early, when it’s easier to care for.

Here are 6 questions to ask your doctor about colon cancer, screenings and how to lower your chances of getting it.

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1. What are the symptoms of colon cancer?

Colon cancer often forms in the last part of your intestine. It usually begins as polyps. These are clumps of abnormal cells. As people age, some of those polyps may turn into cancer. That’s why screenings are so important. They can find polyps.

“In the beginning, you may not be able to tell you have colon cancer,” says Niren Jasutkar, MD. He’s the assistant director of gastroenterology for Optum in Secaucus, New Jersey. So, it’s important to get anything that seems unusual checked out. Talk to your doctor if you notice:

• Discomfort in your stomach area
• Blood in the stool (bowel movement)
• Changes in texture and thickness of your stool
• Weight loss you can’t explain

These symptoms don’t necessarily mean you have colon cancer. But it’s a good idea to bring them up with your doctor.

2. How do I know my chances of having colon cancer?

Certain things can raise your chances of having colon cancer, like:

• Getting older.²
• A family member with colon cancer.
• Inflammatory bowel disease such as Crohn’s disease or ulcerative colitis. (These are types of digestive system problems that affect the lining of the gut.)
• Colon cancer caused by a problem with your genes. (Genes determine what traits are passed down from a mother and father to their child.) Examples include familial adenomatous polyposis and Lynch syndrome.

Black Americans are more likely than others to get colon cancer and die from it.³ Ask your doctor about your chances of having colon cancer and when you should get screened.

3. When do I need to get my first screening test?

Both men and women should get their first colon cancer screening at age 45.⁴ “On your 45th birthday, set up an appointment with your doctor,” says Dr. Jasutkar. During that appointment, your doctor can find the best screening test for you.

If you’re in good health, continue screenings through age 75. And if you’re between 76 and 85, discuss your screening options with your doctor. Screenings are not recommended for people over 85.

4. What are my choices for screening tests? 

You have options when it comes to tests:

• Colonoscopy: This test is done by a doctor. The night before, you’ll drink a formula to clear out your bowels. That will give your doctor a clear view of your colon lining during the screening. Then, the next day at the testing center, you’ll get a sedative to make you feel sleepy.
  
  The test itself takes about 20 to 30 minutes (though it may take longer). Your doctor inserts a lighted tube into your rectum. A scope at the end of the tube will show your doctor whether you have any polyps. If you do, your doctor will remove them during the screening. Colonoscopies are usually done every 10 years.
   
• Fecal immunochemical test (FIT): This one is done at home. A FIT test looks for blood in your stool. You swab a sample of your stool with a special brush and smear it on a card. Then you send the card to a lab.
   
• Stool DNA test: This one is also done at home, and you can do it on your own. It looks for DNA changes and blood in the stool. You collect a stool sample in a special container and mail it to a lab. Stool DNA and FIT tests are done every 1 to 3 years.

Are you age 45 or older but haven’t been screened for colon cancer yet? Talk with your doctor to schedule a screening as soon as possible.

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5. Why might I want to get screened before the age of 45?

Let’s say you have a parent, brother or sister who had colon cancer. That’s important to tell your doctor. Why? Because it means that you should get screened at an earlier age. Your doctor might suggest getting screened 10 years earlier than the age your relative was diagnosed. Let's say you have a parent who was diagnosed at 42. You might need to get your first screening at 32.⁵

Your doctor can help you learn when to get screened if colon cancer runs in your family. “The more information you have about your family history, the better,” says Dr. Jasutkar.

6. What can I do to help lower my chances right now?

Getting screened early is the best way to lower your chances of having colon cancer. But there are changes you can make, too, like:

• Cut down on heavy drinking
• Be more active
• Eat healthy
• If you smoke, quit
• Watch your weight

Colon cancer can be stopped when it’s caught early. Take charge of your health and talk to your doctor about screening tests.

And try some healthy changes. You’ll feel good knowing you’re doing everything you can to protect your health.

Sources

1. American Cancer Society. Key statistics for colorectal cancer. Last revised January 13, 2023. Accessed January 26, 2023.
2. Centers for Disease Control and Prevention. What are the risk factors for colorectal cancer? Last reviewed February 17, 2022. Accessed February 1, 2023.
3. American Cancer Society. Colorectal cancer rates higher in African Americans, rising in younger people. Last revised September 3, 2020. Accessed January 30, 2023.
4. American Cancer Society. When should you start getting screened for colorectal cancer? February 4, 2021. Accessed January 30, 2023
5. National Institutes of Health. Colorectal cancer screening for patients with a family history of colorectal cancer or adenomas. November 2019. Accessed January 26, 2023.

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