By Kristy Warren 

Cancer found in the large intestine is called colon cancer, and it is the second deadliest cancer in Pennsylvania. The good news is that this form of cancer is highly treatable when caught early. In some cases, colon cancer can even be prevented by removing pre-cancerous cells before they have a chance to fully develop into cancer. 

Colon cancer almost always begins with a pre-cancerous growth called a polyp. During a preventive screening like a colonoscopy, your healthcare provider can identify and remove these pre-cancerous growths before they can develop into cancer. Unfortunately, many patients skip the screenings that identify and prevent colon cancer. 

More good news: screening for colon cancer has never been easier with multiple screening options now available, including take-home kits. Our Laurel Health experts share what GI symptoms to watch for, when to start screening, ways to screen, and how to select the right test for you by better understanding your screening options for colon cancer. 

So, what is the colon? Is the rectum part of the colon? You may hear different terms used interchangeably when talking about the colon or see specific areas of the colon referenced by other names when reading about colon screenings. Here are the terms to know: 

• Colon is another name for the large intestine or large bowel. The colon is one long, continuous tube, but medical experts use specific terms for certain sections of that tube to better describe its function or where something is located within the colon.
  
  
• Colon cancer refers to cancer that develops in the large intestine. 
  
  
• Rectum: the rectum is the final section of the colon that leads up to the anus; it stores your stool (feces) shortly before you are ready to poop. The rectum is part of the colon, but it has its own name to describe its location within the large intestine and its unique functions. Cancer found in the rectum portion of the colon is called rectal cancer; you may also hear the umbrella term "colorectal cancer" used to refer to cancers occurring in the rectum and colon.
  
  
• Anus refers to the short internal canal and sphincter that manage defecation (pooping); it is located at the end of the rectum and marks the end of the digestion track.
  
  
• Polyps are growths found in the colon and are made up of extra tissue. While a polyp will not necessarily develop into cancer, colon cancer almost always begins via polyps, which is why doctors screen for them and proactively remove them during colonoscopies. If polyps are removed while they're benign, they cannot develop into cancer over time.
  
  
• Gastrointestinal tract (GI tract) refers to your digestive system. Your digestive tract is the path food takes as it is consumed and processed by your body to extract nutrients. Your stomach, small intestine, and large intestine all play important roles in the processing and absorption of nutrients.  

Preventive screenings make a big difference when it comes to colon cancer. This is because cancer in this area of the body almost always begins with a precancerous growth called a polyp. Preventive screenings help your healthcare provider to identify the presence of polyps and remove them before they have enough time to progress into cancer. 

It's important to talk to your family doctor about your screening options for colon cancer. Despite the importance and effectiveness of colon screening options, nearly half of Americans who need them aren’t getting them.

Many delay colon screenings because they’re nervous about preparing for or having a colonoscopy. 

Colonoscopies are considered the gold standard of colon cancer screenings because they allow proactive polyp removal during the exam, but they aren’t your only colon screening option. If concerns about getting a colonoscopy are holding you back from scheduling this important preventive screening, talk with your healthcare provider about all of your screening options. Together, you can develop a screening plan that works for you. 

When we think of colon cancer screenings, we usually think of colonoscopies, but there are now a variety of screening options for colon cancer. Some patients are more comfortable taking a basic screening test as their first step. Testing kits may even be used at home instead of at a doctor's office.

Stool testing kits and imaging scans are two common tools for checking your colon's health. If you are due for a colon screening but aren't ready to schedule a colonoscopy, your provider may recommend starting with an alternative test. These tests are less invasive and don't generally require sedation, but keep in mind that they cannot treat any concerns found during the test, meaning a colonoscopy may still be needed to further diagnose, evaluate, or treat any problems. 

Stool tests: These kits allow you to collect a fecal sample in the privacy of your own home then either mail the sample or drop off the sample at your doctor's office or a designated lab. These at-home tests look for traces of blood or specific proteins / chemicals in your stool (poop) that may indicate colorectal problems or colon cancer. This may be a recommended first step if you are experiencing changes in your bowel movements or GI distress. The results are interpreted by a laboratory and your provider. Positive results require additional testing, and you may need a diagnostic colonoscopy based on the findings.  

Imaging tests: CT imaging scans of the colon, barium contrast enemas, and flexible sigmoidoscopy (a scope reviewing only the bottom third of the colon) allow healthcare providers to image part of your colon to look for polyps and other issues. They do not, however, allow providers to remove polyps when found. If they are discovered when imaging your belly, you will need a traditional colonoscopy or surgery to biopsy and remove them.

Colonoscopy: This test is considered the best screening tool for colon cancer because it allows doctors to fully image the entire colon and remove polyps proactively during the exam, meaning patients likely won’t need to have a second exam. Colonoscopies are a routine screening that is effective, safe, and covered by insurance. They also do not require significant recovery time in most patients.

Occasional changes to your bowel movements or bouts of GI distress can be normal, but if you experience the following symptoms, it's important to talk to your family doctor: 

• Unexplained weight loss 
  
  
• Blood in your stools (poop)
  
  
• Ongoing belly pain
  
  
• Anemia
  
  
• Chronically narrow stools (poop)

These symptoms can be warning signs of colon cancer and other serious GI issues. If you are experiencing these signs, make an appointment with your healthcare provider to get checked out. 

Most people should have their first colorectal screening between age 45 and age 50, but if you are considered high risk for developing colon cancer, have a family history of pre-cancerous polyps or colon cancer, or have certain digestive disorders, you may need to be screened earlier. Talk to your healthcare provider for a personal recommendation on when you should begin screening for colon cancer. 

Together, you and your family medicine provider will determine which screening test works best for you. The important thing is that you get screened. Don’t just “go with your gut”—protect it with a preventive colon cancer screening!

Have a question about colon cancer screenings or need a family doctor? We're here to help. The Laurel Health Centers have you covered with experienced medical experts throughout Tioga, Bradford, and Sullivan Counties. Visit our provider directory or Laurel Health locations directory to find a great provider close to you.