We have made great strides in preventing, detecting and treating colon cancer. Despite a steady decrease in colorectal cancer among older Americans, many more lives could be saved with appropriate screening and early treatment, says Mechu Mey Narayanan, MD.

March is National Colorectal Cancer Awareness month.
Colorectal cancer is prevalent among older adults, and its risk increases as one ages, she says. About 60% of colorectal cancer patients are over 70 at the time of diagnosis and 43% are over 75. Fortunately, however, from 2009 to 2013, the incidence rates of colorectal cancer decreased by 4.6% per year in individuals age 65 and older and by 1.4% per year in those 50-64. Meanwhile, mortality decreased by about 1% per year in people 50-64 years of age and by 3% per year in those 65 and older from 2005 to 2014.

“The widespread use of colonoscopy beginning at age 50 and more effective treatment options can be credited in large part for this decrease,” she notes. “But many more lives could be saved if everyone over 50 had suggested screening. For this reason, St. Luke’s University Health Network has launched a campaign to educate patients about the importance of colorectal cancer screening.”

According to statistics about one in three adults over 50 has never been screened. "Many people put off colorectal screening until they have symptoms, but at that point it is no longer screening. Often symptoms don’t appear until the disease has reached advanced stages or there are no changes at all. By then, the patient’s chance of cure is much lower and the treatment needed is much more intense,” Dr. Narayanan says.”

Common symptoms include blood in the stool, black tarry stools, unexplained weight loss, changes in bathroom habits, thin stools, abdominal pain, bloating, fatigue and anemia.
“Patients often tell me they delayed getting a colonoscopy because they feared the preparation or had concerns about pain,” she says. “The preparation is not pleasant, but after they’ve had the procedure, most of my patients tell me that the prep wasn’t so bad after all. Usually patients wake up from the procedure with minimal pain. An anesthesiologist is a part of the team providing care and works to keep patients safe and comfortable during the procedure.”

"Before a colonoscopy, patients must clean out their colon by taking laxatives. During the procedure the patient is sedated, while the physician places a small, thin endoscope into the rectum and up into the colon to look for precancerous growths known as polyps", Dr. Narayanan explains. If found, the polyps are removed which decreases the risk of colon cancer.
Other screening methods include the Fecal Immuochemical Test (FIT), which involves the patients obtaining a stool sample and sending it to a lab to see if blood is present. Another option is Cologuard, which screens stool samples for DNA markers that help identify colon cancers. Should either test be positive, the patient then requires a diagnostic colonoscopy.

“Be sure to talk to your doctor to determine which test is best for you,” Dr. Narayanan says. “But don’t put it off, your life could depend on it.”

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