Thank you to Dr Patel for joining us at Jacobs Oncology Conference today and reviewing colon cancer screening!
Increased Incidence in Colon Cancer Diagnosis in Ages <50 years! Left-sided colorectal cancer rates have been increasing in the population less than 50 years, therefore some new guidelines suggest starting screening at 45 years of age. The incidence is increasing every year. This is not completely understood, however many environmental factors may be contributing to this increase!
Environmental Risk Factors for Colorectal Cancer: Red meat intake (RR 1.5), Obesity (RR 1.5), Alcohol consumption >4 drinks/week (RR 1.4), Cigarette use (RR 1.5)
Screening Modalities: FOBT/FIT testing (quick to use, no dietary restrictions, inexpensive, however lacks sensitivity for early disease, requires annual administration and a positive results needs a colonoscopy), Stool DNA Tests (non invasive, 90% sensitive, however requires 24 hours stool collection and may still lead to false negatives), Flex sigmoidoscopy, and colonoscopy (can detect AND remove precancerous growths, less frequent testing, but more invasive, resource intensive, and completion is low)
SCREENING: AVERAGE RISK patient should be screened from ages 50-75 years
-Annual Screening with high-sensitivity FOBT/FIT (low sensitivity)
-Annual Screening with stool DNA tests (Cologuard)
-Sigmoidoscopy every 5 years, high sensitivity FOBT every 3 years
-Screening colonoscopy every 10 years
SCREENING: POSITIVE FAMILY HISTORY (first degree relative or multiple second degree relatives)
-Colonoscopy every 5 years starting at age 40 ears or ten years before the youngest case in the immediate family