PT Health Life – Colorectal cancer is a common type of cancer, mostly caused by colorectal polyps. Today, screening for early detection and treatment of polyps at risk of cancer contributes to limiting the increase in the rate of colorectal cancer patients.
Here’s what you need to know about colorectal cancer screening
1. Who needs colorectal cancer screening?
Anyone can be screened for colorectal cancer , but if they cannot afford it, people at high risk should pay attention. People at high risk of colorectal cancer are those aged 50 and over, especially people over 70 years old who need colorectal cancer screening.
People with a family history of colorectal cancer. For this population, a complete colonoscopy is needed.
Other people who have symptoms: rapid weight loss, abdominal pain , bloating, loose stools, bloody stools… can undergo a FIT test (Fecal immunochemical test). If FIT is positive, an endoscopy will be performed. Complete colon to screen for colorectal cancer.
In addition, people who regularly smoke cigarettes and drink alcohol; People with colorectal diseases such as chronic enteritis, ulcerative colitis , duodenal ulcers, Crohn’s disease; People who are overweight, obese, and sedentary; diet lacking in fiber, green vegetables and fruits; Abusing fat, salt and processed foods, pickled foods, smoked foods… should also pay attention to colorectal cancer screening.
2. Tests to do when screening for colorectal cancer
There are currently many colorectal cancer screening methods, each with its own advantages. Depending on the specific circumstances that the doctor prescribes, patients can choose.
Colonoscopy: Colonoscopy allows the doctor to observe the entire lining of the colon. Patients need to abstain from eating and drinking before colonoscopy and clean their intestines. Colonoscopy can detect all lesions in the colon: small polyps and large polyps, early cancer, inflammation, ulcers… Lesions can be removed within allowable capacity.
CT colonography. A non-invasive method that helps doctors detect large tumors or polyps in the colon. In addition, other lesions in the abdominal cavity can be detected.
Stool test: Colon cancer often releases small amounts of blood and abnormal DNA in the stool. Stool tests can detect abnormal blood and DNA.
Fecal occult blood test: The patient self-collects 2 stool samples from 3 consecutive toilet visits, the stool samples are collected at home. Patients should avoid using drugs that irritate the intestines, such as aspirin and anti-inflammatory steroids, before stool collection. This test should be performed annually.
3. When should colorectal endoscopy be performed?
Normally, when screening for colorectal cancer after the first colonoscopy, the patient will be assessed for risk factors.
The time for repeat endoscopy may be shorter if the quality of the previous endoscopy is poor or there are signs of high risk or some characteristics of the previous endoscopy: incomplete polyp removal, patient condition, medical history. . Endoscopy every 10 years and fecal occult blood test (FOBT) at least every 2 years. Continue endoscopy within 1 year if the patient has at least 5 adenomas.
It is recommended that patients have a repeat screening after 5 years if the first screening had no polyps and the risk is low. Repeat colonoscopy every 3 years for high-risk subjects, except in the cases noted above.
For people with colorectal cancer who have had surgery
- People who have not had a complete colonoscopy before surgery, for example: surgery due to obstruction, should have a colonoscopy again after 3-6 months.
- If you have had a colonoscopy, the entire colon before surgery, you need to repeat the colonoscopy after 1 year: if the results are normal, you should repeat the colonoscopy after 3 years. If the results of the second endoscopy are normal, the endoscopy should be repeated every 5 years. If adenoma is detected, repeat endoscopy every year.
- Routine CEA testing every 3-6 months for 2 years, then every 6 months for up to 5 years. CT scan of the chest, abdomen, and pelvis annually for 5 years.
Special subjects need to be screened for colorectal cancer according to the following indications or suggestions:
- People with a family history of colorectal cancer and colorectal polyps should have a screening colonoscopy at age 40. Colonoscopy every 5 years.
- People with familial adenomatous polyposis (FAP) syndrome need a colonoscopy every 1-2 years starting at age 10 and continuously in those who carry the gene mutation. It is necessary to screen for gastroscopy when colon polyps appear or when you are 25-30 years old.
- People with Lynch syndrome (Hereditary non-polyposis colorectal cancer) should have a colonoscopy every 1-2 years, at age 20-25. Gastroscopy from age 30 repeated every 2-3 years.
- People with inflammatory bowel disease (including bleeding ulcerative colitis and Crohn’s) should have a colonoscopy with biopsy to detect dysplasia every 1-2 years, starting 8-10 years after onset; Biopsy of stricture or tumor; Remove polyps if any.
4. Note before going for colorectal cancer screening
- Fast 8 to 12 hours before performing tests and endoscopy.
- Do not drink drinks such as coffee, tea, milk, soft drinks and fruit juices. You should only drink a little water before your appointment.
- Avoid eating foods high in fiber such as green vegetables for a few days. You can eat light foods the night before such as porridge or soup. In case you have to have an endoscopy after 12 noon, you can drink liquids 6 hours before the endoscopy such as water, apple juice, etc.
- You should not smoke or drink alcohol within 24 hours before your appointment.
- For women, cancer screening should only be done 5-7 days after the menstrual cycle. You should notify your doctor in case of pregnancy or suspected pregnancy.
