Colorectal Polyps and Cancer
How Can I Prevent Colorectal Cancer? continued...
Some studies have shown that aspirin and other drugs known as nonsteroidal anti-inflammatory drugs, or NSAIDs, may help prevent colon cancers, but this is usually in patients with familial adenomatous polyps, a condition discussed below. NSAIDs also carry increased risks of serious complications, such as stomach bleeding and heart attacks, so they are not recommended as a general preventive measure for people at average risk for colorectal cancer.
Screening for cancer is another important step.
General Colorectal Cancer Screening Recommendations:
These recommendations are for people at average risk for colorectal cancer without symptoms or a personal or family history of colorectal polyps or cancer or inflammatory bowel disease. Screening should begin at the age of 50.
- Stool tests (fecal occult blood test or fecal immunochemical test) performed once a year. These are simple at-home tests that check for hidden blood in the stool from multiple samples. A colonoscopy should be done if stool test results are abnormal. OR
- Flexible sigmoidoscopy performed every 5 years. This is an outpatient procedure for examining the inside of the lower portion of the large intestine, called the sigmoid colon, and also the rectum. This test can miss polyps, cancer, or other abnormalities that are beyond the reach of the scope. If abnormalities are detected, a colonoscopy needs to be done. OR
- Colonoscopy, performed once every 10 years; this is the preferred test. OR
- Air contrast barium enema performed every 5 years; during this procedure, a barium enema is given and then air is blown in to make the barium spread over the lining of the colon, producing an outline of the inner colon and rectum on X-ray. This test can miss small polyps or cancer. If any abnormalities are detected, a colonoscopy is needed.
- CT colongraphy (virtual colonoscopy) performed every 5 years. this can miss small polyps. If any abnormalities are detected, a colonoscopy is needed.
People at higher risk for colorectal cancer include those with a personal history of polyps on previous colonoscopy, colorectal cancer, and/or inflammatory bowel disease, strong family history of colorectal cancer or precancerous polyps, and a family history of a hereditary cancer syndrome. Screening guidelines for adults consist of screening with colonoscopy starting at a younger age. However, the exact age to start screening and interval of testing depends on specific risk factors.