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Colon Cancer Cases Drop

While new options are available, colonoscopy screening remains the gold standard

Here's what you need to know about colorectal screening:

Don't forget 60 ... and 70

"We put so much emphasis on that first colonoscopy at age 50, but I worry that we've underemphasized the 60 part," Wender said. Getting screened again at 60 is particularly important because there's more likelihood of finding a large polyp. "So that one at 60 is just as important and also 70, if you're in good health." By age 75 — if you've always had normal colonoscopies — you're off the hook and can stop taking the test altogether.

Ask about a take-home fecal test

If you are at average risk, ask your doctor about taking either a fecal occult blood test (FOBT) or a fecal immunochemical test (FIT) every year instead of a colonoscopy. Both test for traces of blood in the stool. The FIT is the newer test and easier to use, but both are what Wender calls "outstanding, evidence-based, guideline-recommended choices." A fecal test that's done every year can save as many lives as a colonoscopy every 10 years, he adds. In fact, a February study by researchers with Kaiser Permanente found that the FIT is able to spot nearly 80 percent of colorectal cancers without making people change their diets or stop taking their medications, as the FOBT requires. The test is completed at home and mailed to a lab. The results are then sent to your doctor. Wender emphasizes, however, that if the fecal test comes back positive, "you must have a colonoscopy. No question."

Consider new options

The Food and Drug Administration recently approved the PillCam Colon, a pill-size battery-operated camera that you swallow so it can take pictures of the inside of the colon. There's also CT colonography, aka virtual colonoscopy, which takes images of the colon using a CT scanner. Neither will let you avoid the laxative prep and they're not covered by all insurance plans, but they are less invasive than a traditional colonoscopy and don't require sedation. However, if a polyp is spotted, you'll have to undergo a colonoscopy anyway. "There's no way around a colonoscopy if they see something on these tests," Wender said.

For low-risk patients, there's sigmoidoscopy

A sigmoidoscopy examines only the lower part of the colon, which is why it's not recommended for those at higher risk of colon cancer. It doesn't require sedation or as much prep — just an enema an hour before the procedure — but a large Harvard study last year found that it's insufficient for preventing cancer in the upper colon. New statistics from the American Cancer Society back that up: 42 percent of colon cancer is found in the upper, or proximal, colon, and 23 percent is found in the lower, or distal, colon.

Candy Sagon is an editor and health writer for AARP Media.

Next page: 2014 Colorectal Cancer stats (Free Infographic). »

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