Colorectal Cancer Screening and Prevention
in Denver

Colorectal Cancer Screening and Prevention

In most cases, colorectal (colon) cancer develops from abnormal growths known as polyps in the colon or rectum. Colorectal cancer screening tests are done to help find polyps so that they can be removed before they turn into cancer.

Regular screening to prevent colorectal cancer should begin in healthy adults (those at average risk) at the age of 45. In 2021, the US Preventive Services Task Force lowered the screening age for colorectal cancer from 50 to 45. Insurers now cover screening colonoscopies as a preventive procedure at this younger age.

In some instances, colorectal screening start before age 45:

• Family History: If you have a first-degree relative who had colorectal cancer or advanced polyps, colorectal cancer screening typically starts at age 40 or 10 years earlier than the relative’s diagnosis (whichever comes first).
• Genetic Syndromes: If you have been diagnosed with a hereditary condition such as Lynch syndrome or Familial Adenomatous Polyposis, screening happens earlier and more often — sometimes in your teens or twenties.
• Inflammatory Bowel Disease (IBD): If you have been diagnosed with ulcerative colitis or Crohn’s disease, surveillance colonoscopies are needed beginning 8 years after diagnosis to monitor for precancerous changes.

Patients have several options for colorectal cancer screening, including:

Colonoscopy at South Denver GI

A colonoscopy is the gold standard in colorectal cancer screening. This is the only tier-one screening test. Colonoscopies detect over 95% of colorectal cancers and precancerous polyps. Colonoscopy screening is the best, and only, way to detect and prevent colorectal cancer.

A colonoscopy will detect abnormalities or changes in the colon and rectum. During this short outpatient procedure, a long, flexible tube with a camera attached called a colonoscope is inserted through the rectum to view the entire colon and large intestine. If needed, abnormal tissue can be removed through the scope during this exam.

In healthy adults, a colonoscopy should be done every 10 years starting at age 45, and more frequently if you have risk factors or a history of polyps or cancer.

Flexible Sigmoidoscopy

This procedure is used to assess the lower part of the colon and rectum. During this exam, a thin, flexible tube with a small video camera attached (sigmoidoscope) is inserted into the rectum. In healthy or average-risk adults, a flexible sigmoidoscopy should be performed every 5 years.

Colonoscopy is considered a better test to screen for polyps and prevent cancer than flexible sigmoidoscopy because it examines the entire length of the large intestine.

Stool Tests

cancer. These stool tests are intended for adults at average risk (not high-risk) for colorectal cancer.

The first is the guaiac-based fecal occult blood test (gFOBT), which uses a chemical called guaiac to detect blood in the stool. The next stool DNA test is the fecal immunochemical test (FIT), which uses antibodies to detect blood in the stool.

The last test is the FIT-DNA test (Cologuard®), which combines the FIT method with a test that detects DNA that has changed in the stool.

Stool tests, including Cologuard, are less sensitive than colonoscopy in detecting colon polyps. They often deliver false positive results and miss more colorectal cancers, including cancers that are more advanced. For example, 9% of the time a Cologuard test will indicate a patient has cancer when they do not. A positive or abnormal Cologuard requires a colonoscopy as a follow-up to complete the screening process.

Shield™ Blood Test

A new, blood-based colon (colorectal) cancer screening test known as Shield™ is now available for average risk patients. This test involves a routine blood draw and must be repeated every 3 years.

While Shield™ can detect colorectal cancer, it cannot prevent cancer the way a colonoscopy does. It is also a less sensitive diagnostic tool than colonoscopy. A one-time Shield™ test may fail to detect one in three early-stage cancers and one in six total cancers.

Per the US Preventive Services Task Force, Shield™ is not intended to replace screening tests that are recommended by appropriate guidelines such as colonoscopy, sigmoidoscopy and high sensitivity fecal occult blood testing. Like stool tests, a positive or abnormal Shield™ test requires a colonoscopy.

What to do if you get a positive Cologuard or Shield™ blood test

If you receive a positive Cologuard or Shield™ blood test result, your next step is to schedule a colonoscopy.

A positive Cologuard or Shield™does not necessarily mean you have colorectal cancer. It means there is something abnormal. A colonoscopy will confirm if cancer or precancerous polyps are present. The procedure allows gastroenterologists to look directly at your colon and remove polyps if they find them.

Cologuard FAQs

Professional and respectful from the get-go. Very efficient systems in place, courteous admin staff and extremely helpful and caring nursing staff. No one likes to have these tests, but this is a good place to be if you have to have them.

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The front staff was immediately attentive as soon as I walked in. The nurses and PAs were professional and very nice, and the doctors were even better. The procedure went smoothly and could not have gone better. Of course, having positive lab results makes it easier to post a glowing report but I got the impression that if I had been diagnosed differently, they would have taken care of me with the same kindness and dedication.

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My experience with South Denver GI has been outstanding. Everyone I have met on the staff is exceptionally professional with tremendous people skills. Top-notch practice that I would unequivocally recommend to anyone.

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