Early detection and screening for colorectal cancer

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Colonoscopy is an early detection tool for colorectal cancer, which is more prevalent in people older than age 50. Black Americans are 20% more likely to develop the disease than any ethnic group.

When it comes to colorectal cancer, early detection can save lives.

Colonoscopy is not a glamorous process but vital in diagnosing colorectal cancer early. Colorectal cancer can be one of the deadliest cancers in people ages 20-49 years old.

“One of the biggest trends in cancer in the last 20 years is that we've seen increasing rates in young people of colorectal cancer,” Dr. Adam Kuykendal of Novant Health said. “It still is a disease of older individuals. Eighty percent of cases are still in individuals over the age of 54 or so, but 20% are in patients younger than 54 and back in the ‘90s, that was around 10%. So, it has gone up in these last 20 years, just based on factors we don't fully understand. We are seeing younger individuals — younger than 50 — getting this disease, and when they get it… they can be diagnosed at later stages.”

For the Black community, regular screening is important. Colorectal cancer rates among African Americans are the highest of any racial or ethnic group at 20% more likely to develop the disease and 40% more likely to die from it. 

“Some of the reasons may be due to access to health care providers,” Kuykendal said. “Being able to get in to see a doctor or getting regular screening physicals also are factors. Some, however, might be genetic factors specific to certain communities or races where we see more in the African American population, so that is possible that certain genetic findings could lead to increased rates. I think a combination of all of these things point to why we see some of these disparities.”

Kuykendal’s advice: Get screened.

“The purpose of screening is colon cancer tends to develop as a polyp before it becomes a cancer,” he said. “So, if you can find it when it's a polyp and cut it out — which is what they do during the colonoscopy — it will never go on to become cancer, and you can monitor and surveil that, and then you never have to deal with cancer. You're basically dealing with it in a pre-cancer form. But even if you do catch it as a cancer, you want to catch it as early as possible, because an early cancer, like a stage one, is far easier to treat than a stage three or a stage four. Screening catches the pre-cancer. It catches a very early cancer. It tries to get as many people as possible diagnosed early, and keeps their treatments easier, more doable, less risky and less likely.”

Doctors recommend people start colonoscopies around age 45. But, with the trend of younger people developing the disease, Kuykendal says people who notice specific changes in day-to-day health, you may want to consider being screened to catch potential cancer early while it is easily treated.

“Symptom wise, even for individuals under age 45 who have no family history, they should definitely pay attention,” he said. “If you're having a change in your bowels, blood in your stool, a kind of abdominal cramping pain and you're not sure why, it's important to bring them up with your doctor, and potentially go see a GI doctor to discuss why this is going on. You should get evaluated to ensure that you're not having some early signs of colon cancer, as well as any number of other GI health conditions that you can get that are not cancerous.”

If you are diagnosed, stay positive. 

“Most commonly, the first treatment is going to be surgery to remove it,” Kuykendal said, “but that is often a very well tolerated surgery, particularly when it's caught early. Sometimes there will be the addition of chemotherapy or radiation before or after the surgery, depending on where it's found, how advanced it is, some of those things, but for patients who are not stage four, these are curative treatments, and the majority of those patients will be cured by going through those treatments. 

“The good news is that even if you develop it, and even if it's caught at stage three, the majority of people can still be cured, as long as we can take them through several steps to achieve that.”

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