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Colon cancer is one of the most common cancers – and one of the most preventable if precancerous polyps are caught early.

That's why University of Maryland Cancer Network specialists and the American Cancer Society recommend adults ages 45 and older who have an average risk of colon cancer undergo regular screenings for the disease.

"Colon cancer is the only cancer that can be prevented with early detection by screening," said Cherif Boutros, MD, associate professor of surgery at the University of Maryland School of Medicine, medical director of the Tate Cancer Center and chief of surgical oncology at UM Baltimore Washington Medical Center. "Eighty percent of colon cancers start as a polyp before becoming cancer. While these polyps are pre-cancerous, our specialists can safely remove them and prevent progression of the disease."

Who Should Be Screened?

Certain lifestyle factors increase a patient's chance of getting colon cancer, including:

  • Being overweight/obese
  • Sedentary lifestyle/lack of exercise
  • Diet high in red meat
  • Smoking
  • Heavy alcohol use

In addition to age, other risk factors for the disease include:

  • Family history of colon cancer or precancerous polyps (adenomas)
  • Inflammatory bowel disease
  • Inherited syndromes linked with the disease, including Lynch syndrome and familial adenomatous polyposis (FAP)
  • Racial and ethnic background – African Americans and Jews of Eastern European descent are at higher risk

Patients with a first degree relative with colon cancer are at even higher risk and should be screened about 10 years before the age of cancer diagnosis in the relative, UM Cancer Network specialists said.

The good news: Colon cancer cases are decreasing in Maryland, thanks to awareness and increased screenings, Dr. Boutros said. But in recent years, the number of younger patients with the disease has jumped, he said.

"Most colon cancer occurs after the age of 50," Dr. Boutros said. "But these younger populations aren't screened as much as the older populations, so they're not expecting it."

In 2018, in light of these cases, the American Cancer Society lowered the age for screenings to begin from 50 to 45.

What Are The Screening Options?

The UM Cancer Network is actively involved in screening patients throughout its hospitals, Dr. Boutros said. Screening options include:

  • Stool tests
    • Guaiac-based fecal occult blood test (gFOBT), which uses the chemical guaiac to detect blood in the stool
    • Fecal immunochemical test (FIT), which uses antibodies to detect blood in the stool
    • Cologuard, which tests for tumor-specific DNA changes, including aberrant methylated BMP3 and NDRG4, a mutant form of KRAS, beta-actin, and hemoglobin
  • Flexible sigmoidoscopy
  • Colonoscopy
  • CT colonography (virtual colonoscopy)

"There are pros and cons to each screening option, ranging from ease of use to cost," said Phil Nivatpumin, MD, medical director of the Kaufman Cancer Center at University of Maryland Upper Chesapeake Health System. "Stool testings are easy and relatively low cost, but they differ in their sensitivity to actually detect and their false negative rate."

UM Cancer Network specialists can provide physicians and patients with screening guidance, as they are well-versed in all screening methods and the latest technology to detect colon cancer, including DNA testing and genetic counseling, he said. Network social workers can also work with patients to see if they are eligible for free colon cancer screenings through county and state agencies.

"Screening and prevention are high priorities for the network," Dr. Nivatpumin said. "If there are any questions, reach out to someone in the network. And if there's any suspicion of the disease, have a low threshold. Screenings provide high reward and relatively low risk."

Have a question about screening? Contact the UM Cancer Network.