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Finally, there are colorectal screening guidelines that really make sense. For the first time ever, the American Cancer Society, as part of a U.S. Multi-Society Task Force on Colorectal Cancer, has added new and enhanced screening tools to the standard colonoscopy, such as a virtual colonoscopy, to detect colorectal cancer for people of average risk aged 50 and older.*

The importance of proper testing hit close to home almost two years ago when my brother-in-law, who was 53 at the time, was diagnosed with stage 4 colorectal cancer. A year earlier, he told me he had noticed blood in the toilet. He attributed the blood to hemorrhoids. I urged him to see his primary care doctor to get a proper evaluation, which should include a colonoscopy, I told him. A few weeks later, he told me his physician had confirmed what he had first suspected, that he had hemorrhoids. A year later, he developed a bowel obstruction and was diagnosed with advanced colon cancer. I couldn't understand how a cancer that was undetectable a year earlier could have progressed so fast. It turned out that it hadn't. His primary care doctor had performed a sigmoidoscopy in his office and the tumor went undiagnosed because it was located just above the sigmoid colon. Had my brother-in-law had the recommended colonoscopy, chances are the tumor would have been detected much earlier.

The new colorectal screening guidelines leave much less to chance because, for the first time, they state preferences for certain tests that not only detect cancer, but precancerous polyps as well. They include –
• Flexible sigmoidoscopy every 5 years, or
• Colonoscopy every 10 years, or
• Double-contrast barium enema (DCBE) every 5 years, or
• CT colonoscopy (CTC) every 5 years
Tests specific to cancer include –
• Guaiac-based fecal occult blood test (gFOBT) annually
• Fecal immunochemical test (FIT) annually
• Stool DNA test (sDNA) with high test sensitivity for cancer, frequency unspecified
(all performed with high sensitivity for cancer)

These tests may sound like overkill to those of you who are hesitant to undergo either a sigmoidoscopy or colonoscopy. But I assure you, they're not. I urge each and every one of you reading this who is aged 50 and older to have a thorough screening, if you have not already done so. Urge parents and friends to do the same.

You can save yourself from the fate my brother-in-law has had to endure — years of continuous chemotherapy and an urgent hope for a cure.

---

Janice Spillane, RN, MS, is Editorial Director, Nursing Spectrum's New York/New Jersey Metro edition.

www.cancer.org/docroot/MED/content/MED_2_1x_Health_Groups_Issue_Updated_Colorectal_Cancer_Screening_Guidelines.asp?sitearea=MED

To comment, e-mail editorNY@nursingspectrum.com.

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