Why is it important to get colorectal cancer screening?

[CharlieH]

The population of the United States above the age of 50 is about 125 million. Among them, approximately 40 million people, or about one-third of eligible individuals, are not getting screened for colorectal cancer. In Thailand, out of the 72.8 million people, about 30% of the population is above 50 years of age. Probably more than two-thirds of this population are also not getting screened for colorectal cancer.

Colorectal screening is not widely practiced in Thailand due to the lack of resources and availability of gastroenterologists. So far, colorectal screening in Thailand is still in its infancy and not widely implemented. Although the Thai government is trying hard to push colorectal screening programs by encouraging people above the age of 50 to do fecal occult blood tests and, if positive, proceed to colonoscopy, this practice has not been widely adopted.

This fact is concerning, given that colorectal cancer is the third most common cancer diagnosed in the USA and in Thailand, according to Assoc. Prof. Dr. Sathaporn Manatsathit, a Gastroenterology & Hepatology specialist at MedPark Hospital Bangkok.

 

Early detection of colorectal cancer saves lives

The simple answer as to why it is important to get colorectal cancer screening is because it increases the chances of successful treatment and survival.

 

Dr. Manatsathit points out that colorectal cancer screening and diagnostic tests are effective at spotting precancerous polyps (growths on the lining of your colon) before they develop into cancer. During a procedure called a colonoscopy, doctors can remove these polyps, which helps in preventing the disease entirely.

Moreover, the earlier the cancer is caught, the better the chances for successful treatment and recovery. If colorectal cancer is detected at an early stage, it is usually still localised and hasn’t spread to other areas of the body. This makes treatment much simpler and often results in better outcomes for patients. “Studies show that early-stage colorectal cancer can have a near 100% five-year survival rate,” adds Dr. Manatsathit.

When should you undergo colorectal cancer screening?

As people get older, their chances of getting colorectal cancer increase, says Dr. Manatsathit. Therefore, it is recommended that anyone over 50 get regular screening for colorectal cancer. Screenings should start even earlier, at around age 40, if there’s a family history of the disease or any other risk factors.

Your doctor will recommend a specific screening schedule. In general, people with a clear colonoscopy, meaning no polyps or adenomas (non-cancerous tumours), should have their next one in 5 to 10 years. If the previous exam revealed 1 or 2 polyps smaller than 1 cm, the follow-up should occur in 3 years. For those with polyps or adenomas larger than 1 cm, the doctor will likely recommend the next colonoscopy within 1 to 2 years. However, these timelines may vary based on specific histological findings and the doctor’s advice.

The risk factors and symptoms

It is still unclear what causes colorectal cancer, but the two main risk factors associated with it are genetic and environmental or lifestyle factors. Genetic factors don’t always come directly from your parents; sometimes, they can skip generations. If you have a close family member, such as a parent, sibling, or child, who has had colorectal cancer or adenomatous polyps (a type of polyps that can change into cancer), your risk of developing the disease increases.

On the environmental side, there are various things that can increase risk, too. For example, exposure to certain carcinogens, like smoking or consuming grilled and smoked meats, can be harmful. A diet high in red meat and low in fibre, along with processed foods and heavy alcohol consumption, as well as not exercising enough and being overweight, can all contribute to higher risks, too. Additionally, some medical conditions, e.g. Inflammatory Bowel Disease both ulcerative colitis and Crohn’s disease, Lynch syndrome, Familial Adenomatous Polyposis (FAP), Type 2 diabetes, Acromegaly, etc., also raise the likelihood of developing colorectal cancer.

Since age plays a role in the development of colorectal cancer, adults over the age of 50 should undergo fecal occult blood tests and/or colonoscopy for colorectal screening, even if they have no gastrointestinal (GI) symptoms. If they wait until symptoms appear, it may be too late, as the polyps, adenomas, or tumors may be large enough to produce symptoms. Therefore, it is always wiser to get screened once they pass the age of 50 and not wait for symptoms to appear. People at high risk or with a family history of colon cancer should start colorectal screening at age 40 or 45. Regardless, any gastrointestinal symptoms should prompt serious consideration for screening. Symptoms to watch for include:

 

Should you get colorectal cancer screening even without symptoms?

Yes, as mentioned above, you should still consider colorectal cancer screening as a precautionary measure, even in the absence of symptoms.

“Colorectal cancer can progress silently for quite some time,” Dr. Manatsathit says. The disease is often called a silent killer because it takes years to progress to a point where you experience symptoms. Many only seek screening after seeing blood in their stool or having bowel blockages. Some don’t realise there is a problem until the cancer has spread to other organs like the lungs or liver. However, by the time patients notice these symptoms, the cancer is often at a more advanced stage and harder to treat.

What are the different types of colorectal cancer screenings?

 

Dr. Manatsathit explains that colonoscopy is the main screening tool at MedPark Hospital. This procedure is highly accurate and effectively locates tumours. During the procedure, your doctor will insert a long, flexible instrument called a colonoscope to examine the entire colon and rectum. Again, if your doctor discovers any polyps or adenomas, they will remove them immediately to prevent future development of cancer. Your doctor may also take tissue samples for further testing during the process.

Many find colonoscopy to be painless, while others may feel agitated, anxious, or experience some annoying pain. You can request your doctor to perform it with an anaesthetist, who can help you relax by administering stronger sedatives under their monitoring, further minimising discomfort. You will recover or regain consciousness almost immediately once the colonoscopy procedure is finished.

From the patient’s point of view, the most difficult part is the preparation of the bowel and the bowel cleansing from the laxatives your doctor provides, as well as the fasting for six hours before the procedure. The purpose of intense cleansing is to clear any stools that may cause blind areas from the residual stools. This means avoiding a low-fibre diet, such as vegetables, fruits, grains, nuts, and seeds, for a few days prior to the procedure. Still, some people tend to avoid it because it involves a rigorous bowel cleansing process and fasting beforehand.

There are alternatives to consider, such as an annual stool test that checks for hidden blood or occult blood. However, if this test shows positive results, your doctor will usually advise you to undergo a colonoscopy anyway. For those who prefer another method, CT colonography is an option. This is less invasive than a traditional colonoscopy but requires intense cleansing and also involves exposure to radiation. If the CT colonography is negative, it is fine. But if your doctor finds polyps or adenomas during a CT colonography, you will still need a colonoscopy for removal.

Stool genetic testing is also available as an alternative screening method. It is a non-invasive method for screening colorectal cancer, involving the analysis of a stool sample for abnormal DNA and blood, which can be early indicators of colon cancer or precancerous polyps. You can collect a stool sample at home or collect blood samples at the hospital and send them to a laboratory for analysis.

• DNA analysis: The lab examines the DNA in the stool sample for specific genetic markers associated with colorectal cancer.
• Blood genetic analysis: These can identify genetic mutations associated with an increased risk. The lab analyses your DNA for specific gene mutations linked to hereditary colorectal cancer syndromes like Lynch syndrome and familial adenomatous polyposis (FAP).

If you have a strong family history of colorectal cancer, especially at a young age, and you do not want to undergo a colonoscopy, your doctor may recommend genetic testing. It is important to note that the test does not confirm or rule out colorectal cancer. It just helps to assess your risk and guide you in screening recommendations. Please note that it is less sensitive than a colonoscopy and may not detect all precancerous polyps. However, it may help determine how often you should have a colonoscopy based on your risk level. Sometimes the test can produce a positive result when no cancer or polyps are present, requiring further testing. Therefore, its reliability should be discussed with your doctor.

What happens if your doctor finds abnormalities during a colonoscopy?

The plan for follow-up care after finding something abnormal will vary based on what your doctor discovers during the procedure. For instance, if your doctor removes non-precancerous polyps, depending on their size and number, they might suggest another colonoscopy in about three to ten years. However, if any polyps are precancerous, more frequent check-ups every one to three years may be necessary to monitor them and remove any new ones that develop.

If your doctor detects inflammation due to conditions like ulcerative colitis or Crohn’s disease, they will recommend appropriate treatments tailored to address those specific issues. In cases where diverticula are present but not causing problems, you may not need any special treatment; however, if diverticulitis occurs, indicating inflammation, you might receive advice on antibiotics and changes in diet.

Lastly, if your doctor finds cancer during the screening, they will quickly refer you to specialists such as a GI surgeon or oncologist, who will help determine the best treatment approach for you. This could include options like surgery or chemotherapy, or even radiotherapy, among others.

It is important to remember that this overview provides general information, and individual circumstances may vary significantly based on specific findings from each person’s colonoscopy.

If it is so important, why don’t more people get colorectal cancer screening?

Many people delay colorectal cancer screening until it is too late due to misconceptions and fears. Here are some of the most common reasons.

I don’t experience any symptoms or have any risk factors

As explained above, colorectal cancer often doesn’t show symptoms until it is advanced. And since this type of cancer can affect anyone, regardless of their health and risk factors, it is a good idea to get a screening as soon as you can.

I’m too young/too old for screening

Older adults may dismiss the necessity of screening, believing they are past the age of concern. However, medical guidelines suggest that regular screenings should continue well into older adulthood. On the other hand, if you’re younger than 40, you might think you’re too young to get colorectal cancer screening – but that’s not true. Although the majority of colorectal cancer cases are found in adults over the age of 50, recent studies show an alarming increase in this type of cancer among those in age of 40 or below.

Colorectal cancer screening is too expensive

Many people avoid getting colorectal cancer screening because they think it is too expensive. In reality, many insurance plans cover the full costs of colorectal cancer screenings. Plus, medical centres like MedPark Hospital understand financial concerns and accept most types of insurance. MedPark also arrange a Package, so that the cost of examination is within reach of your financial burden. This means that you can do it without worrying about a hefty bill afterwards.

Talk to your doctor about screening options and reach out to your insurance provider for more specific details about your plan.

It is too invasive and scary

If you’ve been avoiding colorectal cancer screening because it seems too invasive and intimidating, you’re not alone. It is normal to experience fear and anxiety but remember that there are various screening options available. Some options are minimally invasive and may not require the same level of preparation as others.

Make sure to have open conversations with your doctor about what each option entails. Doctors are there to help by discussing which screening method is the most suitable based on personal comfort levels and health history.

Now is the perfect time for colorectal cancer screening

If you’re thinking about getting a colorectal cancer screening, now is the time, even if you feel fine. Screening plays a crucial role in preventing (and possibly curing) colorectal cancer, and MedPark Hospital is making it easier for people in Thailand to access these services.

The team at MedPark consists of various specialists. These include gastroenterologists, endoscopists, surgeons, radiologists (both general and interventional), oncologists, radiation experts, pathologists, nutritionists, and genetics professionals. Thus, in addition to colorectal cancer screenings, MedPark’s GI Teamwork offers solutions for a variety of gastrointestinal issues that can affect the entire digestive system, from the mouth to the anus, as well as problems related to the liver, pancreas, and abdominal organs like lymph nodes and blood vessels.

 

 

For more information and to book an appointment, visit MedPark Hospital’s website. Remember, screening can save lives!

 

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[hellohello]

The screening age in US is now 45!  CRC is on the rise.

[hellohello]

People born after 1990 have 2 times the risk of developing colon cancer and 4 times the risk of developing rectal cancer than those born in 1950......

[KhunLA]

Assuming the title is a rhetorical statement ... 

 

Get it done as early as you please, especially if your insurance will cover 100% of cost.  Don't assume that minor trace of blood is from your hemorrhoids 

 

I had full coverage in USA, so early 40s had it done, knowing I was going to retire early.  Saying colon cancer runs in the family, and you noticed blood in you BM will get the procedure done for you.

 

Had it done here/TH also, about 5 yrs ago, (65 yrs old ?) and 2 polyps removed.  Memory serves, about ฿12k, and same for endoscopy done at same time, just for the hell of it.   Latter did find a Hiatal hernia, which I passed on simple repair.   Explained those 'GERD' symptoms, and simply adjusting diet and sleeping position 'cured' them.

 

Just for the hell of it, if you are not in TH yet, I compared average price of, at Philadelphia area, PA, USA.  $1400 mark  or ฿50k 

[mfd101]

4 hours ago, hellohello said:

People born after 1990 have 2 times the risk of developing colon cancer and 4 times the risk of developing rectal cancer than those born in 1950......

Which (if true) says a great deal about what younger generations put in their mouths and what they don't do by way of daily exercise.

[BusyB]

A (Thai) friend of mine's father died of colorectal cancer aged 60. Totally unnecessary. When it became symptomatic it was far advanced. All they could do by then was resection his bowel to give him an extra two years.

 

When she gets to 45 I'm gonna make sure my friend gets a colonoscopy.

 

Had two myself. One at 55 (standard, paid by public health insurance) - all clear. Then again at 65 (standard) follow up - this time they removed a small polyp and said come back in three years.

 

Damn sure I will.

 

[PFMills]

I’ve been here full time since 2007. I’ve had four camera up and three camera down. I’m close to 79 now. In the past they gave me another five year appointment but not last time. Wonder if they know something!! Always have it done at Chulabhorn, it’s not very expensive. My wife had the look up and down last month …I’ve just checked the amount 8520thb.

 

I think it’s a little more if they take a sample …but so far that has never happened.

[KhunLA]

25 minutes ago, PFMills said:

I’ve been here full time since 2007. I’ve had four camera up and three camera down. I’m close to 79 now. In the past they gave me another five year appointment but not last time. Wonder if they know something!! Always have it done at Chulabhorn, it’s not very expensive. My wife had the look up and down last month …I’ve just checked the amount 8520thb.

 

I think it’s a little more if they take a sample …but so far that has never happened.

4 times in 17 years, may be a bit of overkill.   Think the new recommendation is every 10 years, if an all clear, or a polyp or 2 are removed.  Also had mine done at Chula, and Q was about 9 months, so paid extra for off hours appointment.  Still cheaper than most places, especially private, which charge the same for one of, instead of both done at same time.

[Sheryl]

10 hours ago, PFMills said:

I’ve been here full time since 2007. I’ve had four camera up and three camera down. I’m close to 79 now. In the past they gave me another five year appointment but not last time. Wonder if they know something!! Always have it done at Chulabhorn, it’s not very expensive. My wife had the look up and down last month …I’ve just checked the amount 8520thb.

 

I think it’s a little more if they take a sample …but so far that has never happened.

As you get older the risks of the procedure vs potential benefits change.

 

Most doctors would agree that for a 79 year old if all prior colonoscopies were normal, can cease doing them.

 

But you could do periodic flstool tests for occult blood. 

 

 

[PFMills]

12 hours ago, Sheryl said:

As you get older the risks of the procedure vs potential benefits change.

 

Most doctors would agree that for a 79 year old if all prior colonoscopies were normal, can cease doing them.

 

But you could do periodic flstool tests for occult blood. 

 

 

Appreciate that Sheryl … thanks

[jas007]

It’s a slow growing cancer, usually, and if detected early, can be stopped.  So, why not check? I know people who died from colon cancer. Totally unnecessary.  Then again, maybe some of you have a death wish?

[Sheryl]

A nonsensical post has been removed. 

[Tazmo]

I had a colonoscopy done in May and removal of 2 polyps, non- malignant.

 Was suffering from diarrhea for 2 months and one of my brothers had colorectal cancer ( diagnosed in his 80’s)!
At first I had several antibiotics which never worked and saw a Gastroenterologist (Asst. Prof) who advised conservative treatment to try before colonoscopy. But it didn’t help and my stool occult blood was positive. So I went ahead with the colonoscopy. The sedation given was excellent, I never felt a thing and it was over quickly. Cost me over 25K Thai baht and follow up histology test showed no cancer. Follow up in a year. But my diarrhea persisted ( even though he said it will get better!)

So I went for a second opinion and saw another Gastroenterologist who diagnosed that I had an Irritable Bowel. He gave me some new medication which helped, but I wasn’t able to keep the follow up appointment.

However, I still have diarrhea unless I avoid certain foods, beer or Guinness 0% alcohol, the yeast seems to set it off ; no fried food, chips or fries in particular; no spicy food ; any milk except for soya!

 Found a new herbal medicine,FyboCalm at Holland and Barrett whilst on vacation in the UK, that helps.

 I will have a check up again, but felt more confident with the second Gastroenterologist, a less expensive hospital than my previous. And he was more thorough and showed understanding.

From my research I couldn’t find any explanation for my condition, I conclude it’s an age thing, in my mid 70’s!

[fredwiggy]

25 minutes ago, Tazmo said:

I had a colonoscopy done in May and removal of 2 polyps, non- malignant.

 Was suffering from diarrhea for 2 months and one of my brothers had colorectal cancer ( diagnosed in his 80’s)!
At first I had several antibiotics which never worked and saw a Gastroenterologist (Asst. Prof) who advised conservative treatment to try before colonoscopy. But it didn’t help and my stool occult blood was positive. So I went ahead with the colonoscopy. The sedation given was excellent, I never felt a thing and it was over quickly. Cost me over 25K Thai baht and follow up histology test showed no cancer. Follow up in a year. But my diarrhea persisted ( even though he said it will get better!)

So I went for a second opinion and saw another Gastroenterologist who diagnosed that I had an Irritable Bowel. He gave me some new medication which helped, but I wasn’t able to keep the follow up appointment.

However, I still have diarrhea unless I avoid certain foods, beer or Guinness 0% alcohol, the yeast seems to set it off ; no fried food, chips or fries in particular; no spicy food ; any milk except for soya!

 Found a new herbal medicine,FyboCalm at Holland and Barrett whilst on vacation in the UK, that helps.

 I will have a check up again, but felt more confident with the second Gastroenterologist, a less expensive hospital than my previous. And he was more thorough and showed understanding.

From my research I couldn’t find any explanation for my condition, I conclude it’s an age thing, in my mid 70’s!

Just had my first one done at 67. No polyps or cancer but they found H Pylori, which was a concern because I had the same symptoms you have. Loose and normal stools , stomach pain, gas. No blood I could see in stool, but did that colonoscopy and endoscopy because I'm 17 years overdue. My daughter had one at 36 and had many polyps removed, so I was concerned. I'm on two antibiotics and an antacid, seems to be working fine. I also stopped coffee, which I love, because it makes you loose. I'll have it every now and then, but not daily like before. Always ate healthy, plenty of fiber, veggies and lean meat and fish, exercised all my life, so I know I helped myself all these years.

[sangtip2]

I read that there is now a blood test which works pretty good.

[KhunLA]

1 hour ago, sangtip2 said:

I read that there is now a blood test which works pretty good.

Interesting .... 'Shield Test'

 

ECLIPSE study demonstrates efficacy of Shield blood-based test for colorectal cancer screening

 

[bkk6060]

A western Doctor told me several years ago to take a good dose of Metamucil 4 to 5 days a week.  Sure keeps me regular and had a Colonoscopy 2 months ago totally clean.  As you get older a good BM sure makes the day.

[nakhonandy]

On 8/9/2024 at 10:38 AM, sangtip2 said:

I read that there is now a blood test which works pretty good.

I'm not sure about that.

However, in the UK they use "stool" testing.

[mokwit]

29 minutes ago, nakhonandy said:

I'm not sure about that.

However, in the UK they use "stool" testing.

Maybe he meant Fecal occult blood test?

[nakhonandy]

15 minutes ago, mokwit said:

Maybe he meant Fecal occult blood test?

That would be the same I guess, if he did indeed mean that.

[mokwit]

One reason to get a colorectal cancer screening is that if it is caught early you could save yourself from a horrible death. Main metastasis sites are peritoneum, liver, and lung.

[sangtip2]

On 8/19/2024 at 1:12 PM, nakhonandy said:

I'm not sure about that.

However, in the UK they use "stool" testing.

https://www.investing.com/news/company-news/fda-approves-first-blood-test-for-colorectal-cancer-screening-93CH-3549508?utm_source=google&utm_medium=cpc&utm_campaign=19277875882&utm_content=659867515420&utm_term=dsa-1463805041937_&GL_Ad_ID=659867515420&GL_Campaign_ID=19277875882&ISP=1&ppu=9801673&gad_source=1&gclid=CjwKCAjw_ZC2BhAQEiwAXSgCljgzTNLMlOZACX_nLYlejMYUCcHkJ4xbtcupmM9lXQa7bpA67nSelRoC_O4QAvD_BwE

[richard_smith237]

On 8/9/2024 at 4:38 PM, sangtip2 said:

I read that there is now a blood test which works pretty good.

 

I think the Blood test is for PSA (which is a marker for prostate cancer - if I'm not mistaken).

 

These threads are good - because I've been putting off having Colarectal-Cancer Screening, because its something I just don't want to to do... no logic in that at all, I know its something I should do... but just don't want to go through the process.

 

Thus: threads such as this are great for people like myself who keep putting this off...

 

This week I'm going to 'go visit a Dr. and state that I saw a dash of blood' and request a scan - which means my work insurance will pay (as i don't think many insurance policies pay for 'pre-emptive' screening and checks as indicated in the article).

 

[mokwit]

4 minutes ago, richard_smith237 said:

but just don't want to go through the process.

I didn't and paid the price - my objection was not the procedure but the prepping - didn't want to spend all night going to the toilet, they now have a prep where you drink it at 6 and you can go to bed by 9 all done. You are knocked out for the actual procedure and know nothing about it.

[richard_smith237]

1 hour ago, mokwit said:

2 hours ago, richard_smith237 said:

but just don't want to go through the process.

I didn't and paid the price - my objection was not the procedure but the prepping - didn't want to spend all night going to the toilet, they now have a prep where you drink it at 6 and you can go to bed by 9 all done. You are knocked out for the actual procedure and know nothing about it.

 

Thanks...  just spoke to the Wife and said I'm going to get this done this week... 

 

Threads like this and comments such as yours help those like me who are reluctant to take the step and require a nudge...   

This is quite a strange situation for me, because if its a knee-operation, or a fully body medical check-up etc (which I take yearly), a trip to the dentist etc - then I have no hesitation whatsoever.

 

Having the chutney tunnel visited by items and eyes unknown (or known to that matter) is somewhat off-putting, I'm fully aware of what an extremely juvenile outlook that is... nevertheless - this is something which really should be done and I'm going to go ahead and pull the trigger so to speak.

 

 

[mokwit]

1 hour ago, richard_smith237 said:

Having the chutney tunnel visited by items and eyes unknown (or known to that matter) is somewhat off-putting, I'm fully aware of what an extremely juvenile outlook that is... nevertheless - this is something which really should be done and I'm going to go ahead and pull the trigger so to speak.

It's a nothingburger. They put you to sleep and you come 'round when it's all over without having felt a thing..