CHRISTUS Health: Learn about colorectal cancer and when to start screenings

CHRISTUS Health recognizes National Colorectal Cancer Awareness Month in March by providing crucial information about the second–deadliest cancer in the U.S. that can be detected early with screenings.

“Colorectal cancer is a cancer found in the colon or rectum, which starts out as a noncancerous tumor or polyp and then slowly becomes invasive,” said Dr. Baochong B. Chang, hematology oncology specialist with CHRISTUS St. Frances Cabrini Hospital in Alexandria, Louisiana. “It is very important to recognize the signs and symptoms of the cancer.”

He said that early on, noncancerous polyps can be asymptomatic. Once the cancer progresses, patients may notice symptoms such as changes in bowel movements, like diarrhea or constipation; the consistency, color and even shape of the stool; and abdominal pain, cramping or bloating.

“We typically recommend starting with a colonoscopy procedure to inspect the inside lining of the colon and rectum,” said Dr. Kevin L. Dean, general surgeon with CHRISTUS Southeast Texas – St. Elizabeth in Beaumont, Texas. “If the patient is hesitant, we can offer an at-home Cologuard test. However, if a patient has high risks such as family history or previous polyps, they are not a candidate for the at-home Cologuard test.”

A colonoscopy is performed while a patient is sedated. A colonoscope, which is a small, lighted camera attached to the end of a long, thin, flexible tube, is inserted through the anus and advanced through the colon to the end. While advancing, air is pumped into the colon to inflate it, and the camera transmits video of inside the colon to a monitor.

Dr. Kai Xia, chief of the department of gastroenterology for CHRISTUS Health Northeast Texas, said the screening colonoscopy remains the “gold standard.”

“The screening colonoscopy is all about prevention, whereas the at-home tests can only detect precancerous polyps and early-stage colon cancer,” she said. “It is why all of the American medical societies recommend that anyone who can get the screening colonoscopy does so.”

The U.S. Preventive Services Task Force now recommends adults start getting screened for colorectal cancer at age 45, five years earlier than the previous guidelines. The change in 2021 was based on the trend of growing cases among younger adults.

Experts aren't sure why there's an increase in younger adults getting colon cancer but point to poor diet, obesity, lack of exercise, tobacco and alcohol use, as well as environmental impacts such as exposure to chemicals as possible factors. Family history also plays a role.

“Early detection increases the chance of a cure,” said Dr. German Almonte, general surgeon with CHRISTUS Santa Rosa Health System in San Antonio. “That is why it’s important to highlight National Colorectal Cancer Awareness Month, so people can learn what it is and when screenings should start.”