Screening Is Key to Reducing Colon Cancer Risk

Richard N. Waldman, MD

By Richard N. Waldman, MD
President, The American Congress of Obstetricians and Gynecologists

Each year, more than 70,000 women in the US are diagnosed with colorectal (colon) cancer. It is the third most common cause of cancer death among women. Fortunately, when caught early, it is highly treatable. Regular screening can significantly reduce your risk.

Colon cancer is a slow-growing disease that develops when polyps—benign growths that form in the colon and rectum—turn cancerous. Approximately 90% of colorectal cancers occur in people older than 50. Women are also at increased risk if they have a first-degree relative younger than 60 (or two or more first-degree relatives of any age) with colorectal cancer or polyps; have had colorectal cancer or polyps themselves; have had bowel disease, such as chronic ulcerative colitis, inflammatory bowel disease, or Crohn’s disease; or have a family history of certain types of colon problems or colon cancer.


All women should be screened regularly for colon cancer beginning at age 50, or earlier for African American women and those with high-risk factors. Some screening methods detect polyps, which may be removed during the exam, and cancer. Other less-invasive screenings only check for cancer, but can also lead to earlier treatment. Talk to your doctor about your screening options, including:

Colonoscopy is the preferred method for colorectal cancer screening. A lighted instrument called a colonoscope is used to examine the entire colon and rectum. Patients are sedated for the procedure, which generally lasts 20 to 30 minutes. Polyps can be removed during the exam. Colonoscopy should be repeated every 10 years.

Flexible sigmoidoscopy examines the lower colon using a lighted flexible tube. Polyps can sometimes be removed during flexible sigmoidoscopy. Sedation may or may not be necessary. Women who choose this procedure should have it every five years.

Double contrast barium enema. Patients are given an enema using contrast dye. X-rays of the colon and rectum are then taken. Women should have this exam once every five years.

Guaiac fecal occult blood test or fecal immunochemical test. Patients collect stool samples at home for several days. Samples are sent to a lab to be checked for hidden blood. These tests must be performed annually. A follow-up colonoscopy will be recommended if the test comes back positive.

You can also ask your doctor about newer, non-invasive screening tests such as virtual colonography (a 3-D imaging exam) and stool DNA testing (detects cancer-related gene changes).

Regular screening saves lives. Get screened using the method you are most comfortable with and most likely to complete. ?

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