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- Is Colorectal cancer screening recommended during the COVID-19 era?

- Colorectal cancer is one of the more preventable cancers therefore screening is essential and should not be delayed. Importantly, some may not demonstrate any signs or symptoms of colorectal cancer which is why screening is so important. Our healthcare team at Montefiore cares about every patient's safety and comfort and should know that careful steps and precautions are being taken to ensure a safe and comfortable environment when they have their colonoscopy such as designated patient treatment areas, rigorous cleaning and use of masks. Patients should talk to their healthcare providers to discuss the different screening options available to them. While there are specific recommendations to start screening based on age and/or family history of colorectal cancer even without any symptoms, if anyone is having signs or symptoms of colorectal cancer including blood in the stools, change in their bowel habits, abdominal pain, weight loss or anemia in their blood work, they should talk to their healthcare provider to make sure they have the appropriate testing done.

- Why is it important to be screened for colorectal cancer?

- Colorectal cancer is the third most commonly diagnosed cancer in the United States and the second leading cause of cancer related deaths in men and women combined. Colorectal cancer is highly preventable and curable if detected early. Getting screened for colorectal cancer allows for the detection and removal of precancerous growths or polyps on the inner lining of the colon or rectum before they can develop into cancer. Screening will also help detect pre-cancer and cancerous polyps that may be at an earlier stage therefore improving the chances of successful treatment. Therefore, early detection is key. The risk for colorectal cancer appears to increase after the age of 50. However, amongst those aged 50 to 75 years, approximately one in three adults still have never been screened. What is concerning is that more recent studies are showing that colorectal cancer is being diagnosed in those younger than age 50 at a rate of approximately one to 2% per year. While the exact reasons for the rise in early onset colorectal cancer are unclear, diet, sedentary lifestyle, positive family history and/or lack of awareness of the symptoms for colorectal cancer may be contributing factors.

- What are the symptoms of colorectal cancer?

- Some patients especially with pre-cancerous polyps or in the earlier stages of colorectal cancer may not have any signs or symptoms which is why screening is important even if you are feeling well. However, if you have any of the following signs or symptoms, you should inform your doctor to discuss further testing. These include change in bowel habits, blood in the stools, abdominal pain and/or unexplained weight loss.

- What age is screening recommended and what are the screening options for colorectal cancer?

- The goal of screening is to detect precancerous polyps and prevent colorectal cancer. Most expert groups recommend starting to screen at the age of 50. However, some including the American Cancer Society recommend beginning at age 45 considering the rise in early onset colorectal cancer cases. Due to higher rates of colorectal cancer in certain ethnic groups, experts also recommend that African Americans begin screening at age 45. However, if you have any symptoms or a positive family history of colorectal cancer, you should discuss this with your doctor as you may need to be screened at a younger age. There are multiple ways to be screened for colorectal cancer including visual based testing such as a colonoscopy or a sigmoidoscopy which uses a thin flexible tube to examine your colon and rectum. This procedure will also allow for the removal of polyps if they are found. Virtual or CT colonography is another alternative that uses x-ray images to examine your colon and rectum and also look for polyps. Stool based testing is another option that can be done in the comfort of your own home which looks for occult or hidden blood in your stool sample. Colonoscopy is the preferred test. However, it is important to be aware of the different options available to you. Your doctor may recommend a certain test be done based on your overall health and your preference. If you do have a test other than a colonoscopy such as a stool test and have an abnormal or positive result, this should be followed by a colonoscopy.

- What are some tips that may help reduce your risk from colorectal cancer?

- There are some healthy habits that may help lower your risk of colorectal cancer. These include maintaining a healthy body weight, increasing your physical activity such as trying to limit the amount of time sitting or lying down and depending on your physical health, taking the stairs and incorporating more walking into your day. You could also try to increase your intake of dietary fiber including fruit, vegetables and whole grains. Also, reducing your intake of red meat and processed meats. These include beef, lamb and luncheon meats such as pre-packaged lunch meats including ham or turkey. You should also try to stop smoking and avoid or limit your intake of alcoholic beverages. If you do consume alcohol, try to limit it to one to two drinks per day. You should also speak to your family and find out if there's anyone with colon polyps or colorectal cancer as this may place you at an increased risk.