Colorectal cancer is the third leading cause of cancer-related deaths in both men and women combined in the United States.  Reducing the number of deaths from colon cancer depends on detecting and removing pre-cancerous colorectal polyps, as well as detecting and treating cancer in its early stages. In fact, colorectal cancer can be prevented by removing pre-cancerous polyps. These polyps may be present in the colon for years before invasive cancer develops.

There are several tests used to screen for colon cancer. Your physician may recommend one test or a combination of tests, depending on your risk factors and health history.

When colon cancer is diagnosed in its early (or localized) stage, survival rates are high, the five-year survival rate is about 90 percent. Because many people are not getting tested, only about four out of 10 are diagnosed at this early stage when treatment is most likely to be successful.  

Description of screening tests

Finding and removing polyps keeps some people from getting colorectal cancer. Tests that have the best chance of finding both polyps and cancer are preferred if these tests are available to you and you are willing to have them.  There are several colon cancer screening tests available.  Speak with your doctor about the screening test that is right for you. Beginning at age 50, both men and women at average risk for developing colorectal cancer should use one of the screening tests below:
 
Tests that find polyps and cancer:
 

• Flexible sigmoidoscopy
• Colonoscopy
• Double-contrast barium enema
• CT colonography (virtual colonoscopy)

• Fecal occult blood test (FOBT) *, **
• Fecal immunochemical test (FIT) every year*, **
• Stool DNA tests*

Who is at risk?
The risk of developing colon cancer generally increases as people get older. Men and women 50 years of age and older are at higher risk for developing colon cancer. African-Americans are more likely than Caucasians to be diagnosed with colon cancer at a more advanced stage and are more likely to die from it.

Aside from age, other risk factors for colon cancer include having:

• Inflammatory bowel disease
• A personal or family history of colon cancer or colorectal polyps
• Certain hereditary syndromes (such as familial adenomatous polyposis [FAP] or hereditary nonpolyposis colon cancer [HNPCC, also known as Lynch syndrome])
• Lifestyle, including a diet high in red meats or processed meats, smoking, excessive alcohol consumption, lack of exercise, and obesity

What tests should I have done?
There are several screening options for early detection of colon cancer. Beginning at age 50, men and women should follow one of these options:

• Flexible sigmoidoscopy every 5 years*
• Colonoscopy every 10 years
• Double-contrast barium enema every 5 years
• CT colonography (virtual colonoscopy) every 5 years
• Fecal occult blood test (FOBT) every year
• Stool DNA test (sDNA), interval uncertain*

*Note: Flexible sigmoidoscopy can be combined with a yearly FOBT. All positive tests should be followed up with colonoscopy. Work with your physician to outline the best plan for you.

Individuals at a moderate or high risk should talk with their doctors about different screening schedules.

Scheduling and having regular tests for colon cancer are important to you and your family. The College of American Pathologists will make every effort to remind you to schedule your examination with an e-mail or text message to your cell phone.